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Hunt-Hess Scale (SAH)

Clinical Presentation

Hunt-Hess Grade

1

Good prognosis with surgical intervention

About

The Hunt and Hess Scale classifies the severity of subarachnoid hemorrhage (SAH) based on clinical presentation. It is used to assess patient condition at presentation, guide surgical timing decisions, and predict prognosis. Higher grades are associated with greater vasospasm risk, higher surgical mortality, and worse overall outcomes. The scale is widely used alongside the World Federation of Neurological Surgeons (WFNS) SAH grading system.

Formula

Hunt-Hess Grade: Clinical assessment scale (Grade 1–5)
Grade 1: Mild headache | Grade 2: Severe headache, CN palsy | Grade 3: Drowsy, mild deficit | Grade 4: Stupor, hemiparesis | Grade 5: Coma

Interpretation

GradeSurgical MortalityPrognosis
1~1%Good
2~5%Good
3~19%Guarded
4~42%Poor
5~77%Very poor

References

  1. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28(1):14-20.
  2. Rosen DS, Macdonald RL. Subarachnoid hemorrhage grading scales: a systematic review. Neurocrit Care. 2005;2(2):110-118.

FAQ

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Disclaimer

For educational and informational purposes only. Not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.