Criteria
Hunt and Hess Grading Scale[116]
Grade I: asymptomatic or minimal headache and slight nuchal rigidity (survival 70%).
Grade II: moderate to severe headache, nuchal rigidity, and no neurological deficits other than cranial nerve palsy (survival 60%).
Grade III: drowsiness, confusion, or mild focal deficits (survival 50%).
Grade IV: stupor, moderate to severe haemiparesis, possibly early decerebrate rigidity, and vegetative disturbances (survival 20%).
Grade V: deep coma, decerebrate rigidity, and moribund appearance (survival 10%).
World Federation of Neurological Surgeons Grading Scale (adapted from Suarez et al.)[1]
Grade I: Glasgow Coma Scale (GCS) score 15. Motor deficit absent.
Grade II: GCS score 14-13. Motor deficit absent.
Grade III: GCS score 14-13. Motor deficit present.
Grade IV: GCS score 12-7. Motor deficit present or absent.
Grade V: GCS score 6-3. Motor deficit present or absent.
Modified Fisher Grading Scale[117]
The Modified Fisher and the Fisher grading scales predict the risk of vasospasm and delayed cerebral ischaemia in subarachnoid haemorrhage (SAH) based on the amount and type of blood on computed tomography.[117][118] The modified version improves the original by incorporating the presence of intraventricular haemorrhage (IVH).[117]
Grade I: focal or diffuse thin SAH, no IVH.
Grade II: focal or diffuse thin SAH, with IVH.
Grade III: thick SAH present, no IVH.
Grade IV: thick SAH present, with IVH.
CT Fisher Scale[118]
Grade I: distribution of blood - none.
Grade II: distribution of blood - minimal diffuse subarachnoid blood or vertical layers <1 mm.
Grade III: distribution of blood - localised clot and/or vertical layer ≥1 mm.
Grade IV: distribution of blood - intracerebral or intraventricular clot with diffuse or no SAH.
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