Acute central nervous system dysfunction resulting in coma can be measured simply and reliably by the Glasgow scale. However, when the injury does not impair consciousness and the patient has aphasia, no comparable scale exists. A complementary scale to assess conscious and aphasic patients is proposed. Preliminary validation has been carried out in acute stroke patients, who commonly suffer neurological deficits without loss of consciousness. A simple standardized scale aids in the monitoring of neurological status, and may help in the assessment of prognosis and therapy.