Subarachnoid hemorrhage classification: Difference between revisions

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{{Subarachnoid hemorrhage}}
{{Subarachnoid hemorrhage}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; {{SaraM}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; {{SaraM}}
==Overview==
According to the [[etiology]], spontaneous subarachnoid hemorrhage may be classified into traumatic, [[Aneurysmal disease|aneurysmal]] and nonaeurysmal subarachnoid hemorrhage.
==Classification==
==Classification==
According to the [[etiology]], spontaneous subarachnoid hemorrhage may be classified into [[Aneurysmal disease|aneurysmal]] and nonaeurysmal subarachnoid hemorrhage.  
According to the [[etiology]], spontaneous subarachnoid hemorrhage may be classified into traumatic, [[Aneurysmal disease|aneurysmal]] and nonaeurysmal subarachnoid hemorrhage.  
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There are several grading scales available for subarachnoid hemorrhage. These have been derived by retrospectively matching characteristics of patients with their outcomes. In addition to the ubiquitously used [[Glasgow Coma Scale]], three other specialized scores are in use.<ref>{{cite journal |author=Rosen D, Macdonald R |title=Subarachnoid hemorrhage grading scales: a systematic review |journal=Neurocrit Care |volume=2 |issue=2 |pages=110-8 |year=2005 |pmid=16159052}}</ref>
===Hunt and Hess Scale===
The first scale of severity, described by Hunt and Hess in 1968:<ref>{{cite journal |author=Hunt W, Hess R |title=Surgical risk as related to time of intervention in the repair of intracranial aneurysms |journal=J Neurosurg |volume=28 |issue=1 |pages=14-20 |year=1968 |pmid=5635959}}</ref>
*Grade 1: Asymptomatic; or minimal [[headache]] and slight [[nuchal rigidity]]. Approximate survival rate 70%.
*Grade 2: Moderate to severe headache; nuchal rigidity; no [[neurology|neurologic]] deficit except [[cranial nerve]] [[palsy]]. 60%.
*Grade 3: Drowsy; minimal neurologic deficit. 50%.
*Grade 4: Stuporous; moderate to severe [[hemiparesis]]; possibly early [[decerebrate rigidity]] and vegetative disturbances. 20%.
*Grade 5: Deep [[coma]]; decerebrate rigidity; moribund. 10%.
===Fisher Grade===
The Fisher Grade classifies the appearance of subarachnoid hemorrhage on [[CT scan]] as an index of vasospasm risk:<ref>{{cite journal |author=Fisher C, Kistler J, Davis J |title=Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning |journal=Neurosurgery |volume=6 |issue=1 |pages=1-9 |year=1980 |pmid=7354892}}</ref>
* Grade 1= No hemorrhage evident
* Grade 2= Subarachnoid hemorrhage less than 1 mm thick
* Grade 3= Subarachnoid hemorrhage more than 1 mm thick
* Grade 4= Subarachnoid hemorrhage of any thickness with intra-ventricular hemorrhage (IVH) or parenchymal extension


===World Federation of Neurosurgeons===
The World Federation of Neurosurgeons classification:<ref>{{cite journal |author=Teasdale G, Drake C, Hunt W, Kassell N, Sano K, Pertuiset B, De Villiers J |title=A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies |journal=J Neurol Neurosurg Psychiatry |volume=51 |issue=11 |pages=1457 |year=1988 |pmid=3236024}}</ref>
* Class 1 - GCS (Glasgow Coma Scale)15
* Class 2 - GCS 13-14 without focal neurological deficit
* Class 3 - GCS 13-14 with focal neurological deficit
* Class 4 - GCS 7-12 with or without focal neurological deficit
* Class 5 - GCS <7 with or without focal neurological deficit


==References==
==References==
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[[Category:Neurotrauma]]
[[Category:Neurosurgery]]
[[Category:Neurosurgery]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Needs overview]]

Latest revision as of 14:03, 13 December 2016

Subarachnoid Hemorrhage Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Subarachnoid Hemorrhage from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

Risk Factors/Prevention
Natural History/Outcome
Clinical Manifestations/Diagnosis
Medical Measures to Prevent Rebleeding
Surgical and Endovascular Methods
Hospital Characteristics/Systems of Care
Anesthetic Management
Cerebral Vasospasm and DCI
Hydrocephalus
Seizures Associated With aSAH
Medical Complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Sara Mehrsefat, M.D. [3]

Overview

According to the etiology, spontaneous subarachnoid hemorrhage may be classified into traumatic, aneurysmal and nonaeurysmal subarachnoid hemorrhage.

Classification

According to the etiology, spontaneous subarachnoid hemorrhage may be classified into traumatic, aneurysmal and nonaeurysmal subarachnoid hemorrhage.

 
 
 
 
 
 
 
 
 
Subarachnoid hemorrhage
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Traumatic
 
 
 
 
 
Aneurysmal subarachnoid hemorrhage
 
 
 
 
 
 
Nonaneurysmal subarachnoid hemorrhage
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ruptured saccular aneurysms
 
Occult aneurysmal
 
Perimesencephalic nonaneurysmal subarachnoid hemorrhage
 
Vascular malformations
 
Intracranial arterial dissection
 
Other causes


References

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