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ROSIER Scale (Recognition of Stroke in the ER)
Distinguishes acute stroke from stroke mimics in the emergency department.
ROSIER Scale (Recognition of Stroke in the ER)
Loss of consciousness or syncope
Seizure activity
New acute asymmetric facial weakness
New acute asymmetric arm weakness
New acute asymmetric leg weakness
New acute speech disturbance
New acute visual field defect
Result0 points
Score <=0: stroke is unlikely, though it is not fully excluded. Consider mimics.
- Stroke likely
- score > 0
When to use
- Rapid ED assessment of possible acute stroke or TIA to guide pathway activation.
Formula
Subtract 1 each for loss of consciousness/syncope and seizure; add 1 each for asymmetric face, arm, or leg weakness, speech disturbance, and visual field defect. Range -2 to +5; a score >0 indicates stroke is likely.
Pearls and pitfalls
- A score <=0 does not exclude stroke; clinical judgement and imaging remain essential.