Hunt-Hess Grading for Subarachnoid Hemorrhage

Score	Description	Mortality Rate
1	No symptoms, or mild headache, mild neck stiffness	30%
2	Moderate to severe headache, neck stiffness, or cranial nerve palsy (e.g., III, IV)	40%
3	Drowsiness or confusion, mild focal deficit	50%
4	Stupor, moderate to severe hemiparesis	80%
5	Deep coma, decerebrate rigidity, moribund appearance	90%

Explanation

The Hunt-Hess grading is used to determine the severity of non-traumatic subarachnoid hemorrhage and should be scored immediately upon presentation; for severe systemic diseases (e.g., HTN, diabetes, severe arteriosclerosis, chronic obstructive pulmonary disease) or severe vasospasm found on angiography, add 1 point to the score.

Patients with subarachnoid hemorrhage can be graded based on clinical presentation to assess surgical risk and prognosis.

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.