Language and neurological assessment in stroke: Rethinking the role of linguistic proficiency in clinical outcomes

Abstract

This correspondence underscores the potential impact of language proficiency on clinical outcomes in patients with acute ischemic stroke (AIS), especially those experiencing large-vessel occlusion (LVO). Citing recent findings that non-English-speaking patients often present with more severe symptoms and poorer discharge outcomes despite receiving comparable treatment, this commentary examines how linguistic barriers may confound clinical assessments such as the NIHSS. From a psycholinguistic perspective, language functions not merely as a medium of communication but as a cognitive instrument that actively shapes the expression of symptoms. We advocate for the incorporation of linguistic competence into stroke assessment protocols to promote equity and diagnostic precision in neurology.