The Hunt and Hess scale is one of the grading systems used to classify the severity of a subarachnoid hemorrhage based on the patient's clinical condition. It is used as a predictor of patient's prognosis/outcome, with a higher grade correlating to lower survival rate. Introduced in 1968, the Hunt and Hess scale is now used less frequently, and has largely been replaced by the World Federation of Neurosurgical Societies classification.
Description grade
- Asymptomatic, mild headache, slight nuchal rigidity
- Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy
- Drowsiness / confusion, mild focal neurologic deficit
- Stupor, moderate-severe hemiparesis
- Coma, decerebrate posturing
It gives an index of the mortality associated with the various grades. The mortality is minimum with grade one and maximum with grade five.
See also
- Subarachnoid haemorrhage
- World Federation of Neurosurgical Societies grading system
References
- Hunt WE, Hess RM. “Surgical risk as related to time of intervention in the repair of intracranial aneurysms.” Journal of Neurosurgery 1968 Jan;28(1):14-20.
- Hunt WE, Meagher JN, Hess RM. “Intracranial aneurysm. A nine-year study.” Ohio State Medical Journal 1966 Nov;62(11):1168-71.
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