Subarachnoid hemorrhage classification: Difference between revisions
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{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}} | {{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}} | ||
==Classification== | ==Classification== | ||
According to the [[etiology]], subarachnoid hemorrhage may be classified into [[Aneurysmal disease|aneurysmal]] and nonaeurysmal subarachnoid hemorrhage. | |||
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{{familytree | | D01 | | | | | E01| | E02 | | E03 | | E04 |D01=Ruptured [[Aneurysmal disease|saccular aneurysms]]|E01=Occult aneurysm|E02=[[Vascular malformations of the brain|Vascular malformations]]|E03=[[Dissection|Intracranial arterial dissection]]|E04=Others}} | {{familytree | | D01 | | | | | E01| | E02 | | E03 | | E04 |D01=Ruptured [[Aneurysmal disease|saccular aneurysms]]|E01=Occult aneurysm|E02=[[Vascular malformations of the brain|Vascular malformations]]|E03=[[Dissection|Intracranial arterial dissection]]|E04=Others}} | ||
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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=== | ===Hunt and Hess Scale=== | ||
Revision as of 16:40, 5 December 2016
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Subarachnoid Hemorrhage Microchapters |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)
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Subarachnoid hemorrhage classification On the Web |
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Risk calculators and risk factors for Subarachnoid hemorrhage classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Classification
According to the etiology, subarachnoid hemorrhage may be classified into aneurysmal and nonaeurysmal subarachnoid hemorrhage.
| Subarachnoid hemorrhage | |||||||||||||||||||||||||||||||||||||||||||||||
| Aneurysmal subarachnoid hemorrhage | Nonaneurysmal subarachnoid hemorrhage | ||||||||||||||||||||||||||||||||||||||||||||||
| Ruptured saccular aneurysms | Occult aneurysm | Vascular malformations | Intracranial arterial dissection | Others | |||||||||||||||||||||||||||||||||||||||||||
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.[1]
Hunt and Hess Scale
The first scale of severity, described by Hunt and Hess in 1968:[2]
- Grade 1: Asymptomatic; or minimal headache and slight nuchal rigidity. Approximate survival rate 70%.
- Grade 2: Moderate to severe headache; nuchal rigidity; no 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:[3]
- 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:[4]
- 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
- ↑ Rosen D, Macdonald R (2005). "Subarachnoid hemorrhage grading scales: a systematic review". Neurocrit Care. 2 (2): 110–8. PMID 16159052.
- ↑ Hunt W, Hess R (1968). "Surgical risk as related to time of intervention in the repair of intracranial aneurysms". J Neurosurg. 28 (1): 14–20. PMID 5635959.
- ↑ Fisher C, Kistler J, Davis J (1980). "Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning". Neurosurgery. 6 (1): 1–9. PMID 7354892.
- ↑ Teasdale G, Drake C, Hunt W, Kassell N, Sano K, Pertuiset B, De Villiers J (1988). "A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies". J Neurol Neurosurg Psychiatry. 51 (11): 1457. PMID 3236024.