Clinical Grading Scales in Subarachnoid Hemorrhage

The Migraine And Headache Program

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Botterell scale Grade

Conscious, with or without signs of bleeding in the subarachnoid space I

Drowsy, without significant neurological deficit II

Drowsy, with significant neurological deficit III

Major neurological deficit, deteriorating, or older with preexisting cerebrovascular disease IV

Moribund or near-moribund, failing vital centers, extensor rigidity V

Hunt-Hess scale Grade

Asymptomatic or mild headache I

Moderate to severe headache, nuchal rigidity, may have oculomotor palsy II

Confusion, drowsiness, or mild focal signs III

Stupor or hemiparesis IV

Coma, moribund appearance, and/or extensor posture V

World Federation of Neurologic Surgeons (WFNS) scale Grade

Glasgow Coma Scale score 15:

- no headache or focal signs I Glasgow Coma Scale score 15:

- headache, nuchal rigidity, no focal signs II Glasgow Coma Scale score 13-14:

- may have headache, nuchal rigidity, no focal signs III Glasgow Coma Scale score 13-14:

- may have headache, nuchal rigidity, or focal signs IVa Glasgow Coma Scale score 9-12:

- may have headache, nuchal rigidity, or focal signs IVb Glasgow Coma Scale score 8 or less:

- may have headaches, nuchal rigidity, or focal signs V

Cooperative Aneurysm Study scale Grade

Symptom-free I

Mildly ill, alert and responsive, headache present II

Moderately ill III

- Lethargic, headache, no focal signs

- Alert, focal signs present

Severely ill IV

- Stuporous, no focal signs

- Drowsy, major focal signs present

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