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Hunt & Hess Grade

Hunt & Hess (1968)

Clinical severity grading (I–V) of subarachnoid hemorrhage based on headache, meningismus, level of consciousness and focal deficit. Higher grades predict higher mortality and perioperative risk.

Also searched as: subarachnoid hemorrhage · clinical grading · prognosis · subarachnoid · aneurysm · sah

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The Hunt and Hess scale (1968) stratifies patients with aneurysmal subarachnoid hemorrhage by clinical state at presentation: grade I asymptomatic or minimal headache; grade II moderate-to-severe headache and nuchal rigidity with at most a cranial nerve palsy; grade III drowsiness, confusion or mild focal deficit; grade IV stupor and moderate-to-severe hemiparesis; grade V deep coma with decerebrate posturing. In the original description, serious systemic disease or angiographic vasospasm advances the patient to the next higher grade. The scale remains a standard descriptor of admission status and a prognostic indicator, complementing imaging scales such as Fisher and modified Fisher.

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Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

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