The Hunt and Hess scale, introduced in 1968, 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. Other scales which describe the clinical presentation of subarachnoid hemorrhage patients include the
World Federation of Neurosurgical Societies
The World Federation of Neurosurgical Societies (WFNS), founded in 1955, in Switzerland, as a professional, scientific, non governmental organization, is composed of 130 member societies: consisting of 5 Continental Associations ( AANS, AASNS, C ...
classification, which combines consciousness and motor deficit in its scoring.
The scale is named for Dr. William E. Hunt (26 November 1921 - 26 January 1999) and Dr. Robert McDonald Hess (24 June 1931 - 3 October 2019)
Description grade
#
Asymptomatic, mild
headache, slight nuchal rigidity
#Moderate to severe headache, nuchal rigidity, no
neurologic
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
deficit other than
cranial nerve palsy Palsy is a medical term which refers to various types of paralysisDan Agin, ''More Than Genes: What Science Can Tell Us About Toxic Chemicals, Development, and the Risk to Our Children;; (2009), p. 172. or paresis, often accompanied by weakness a ...
#Drowsiness, confusion, mild focal neurologic deficit
#
Stupor, moderate-severe
hemiparesis
Hemiparesis, or unilateral paresis, is weakness of one entire side of the body ('' hemi-'' means "half"). Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medi ...
#
Coma, decerebrate posturing
It gives an index of the mortality associated with the various grades. The mortality is minimum with grade 1 and maximum with grade 5.
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.
Diagnostic intensive care medicine
Neurotrauma
Medical scales