Scale, Hunt and Hess
The Hunt and Hess scale[1] is used to classify the severity of a subarachnoid hemorrhage based on clinical condition. It can be used to predict patient's prognosis/outcome.
| Grade | Clinical Presentation |
|---|---|
| 1 | Asyptomatic, mild headache, slight nuchal rigidity |
| 2 | Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy |
| 3 | Drowsiness, confusion, mild focal neurologic deficit |
| 4 | Stupor, moderate-severe hemiparesis |
| 5 | Coma, decerebrate posturing |
* Extra one point is given for severe systemic disease or severe vasospasm on angiography.
Comments
When the Hunt and Hess scale is applied upon the patient's arrival at the hospital, it could be misleading. For example, a comatose patient with significant hydrocephalus could become a GCS 15 after the placement of an external ventricular drain.