File Name: hunt and hess scale .zip
Risk factors for mortality after subarachnoid hemorrhage: a retrospective observational study. Subarachnoid hemorrhage is an important cause of morbidity and mortality.
We are thankful for interest 1 in our recently published 2 ruptured brain arteriovenous malformation AVM grading scale, and the opportunity to respond. Hemorrhage volume and AVM size are important considerations in the management of intracranial bleeds. Indeed, other studies have demonstrated the relationship between intracerebral hemorrhage ICH volume and patient mortality eg, ICH score 3 , and the role of AVM size in surgical decision-making eg, Spetzler-Martin score 4. While the objectives of these studies are distinct from the purpose of the RAGS score ie, to predict clinical outcomes based on initial clinical presentation after AVM rupture , we also believed AVM size and hemorrhage volume were important, so they were included in initial models.
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Enter your email address and we'll send you a link to reset your password. This scale assumes you have a grasp of the neurological clinical examination, such as the assessment of level of consciousness, cranial nerves, and motor examination. Please fill out required fields. William E.
The Hunt and Hess scale , introduced in , is one of the grading systems used to classify the severity of a subarachnoid hemorrhage based on the patient's clinical condition. Other scales which describe the clinical presentation of subarachnoid hemorrhage patients include the World Federation of Neurosurgical Societies classification, which combines consciousness and motor deficit in its scoring. The scale is named for Dr. William E.
Numerous systems are reported for grading the clinical condition of patients following subarachnoid hemorrhage SAH. This article reviews the advantages and limitations of these scales as well as more recent proposals for other grading systems based on these scales with or without addition of other factors known to be prognostic for outcome after SAH. There remain substantial deficits in the literature regarding grading of patients with SAH. Most grading scales were derived retrospectively, and the intra- and interobserver variability has seldom been assessed. Inclusion of additional factors increases the complexity of the scale, possibly making it less likely to be adopted for routine usage and increasing only marginally in some cases the ability to predict prognosis. Until further data are available, it is recommended that publications on patients with SAH report at least the admission GCS as well as factors commonly known to influence prognosis, such as age, pre-existing hypertension, the amount of blood present on admission computed tomography, time of admission after SAH, aneurysm location and size, presence of intracerebral or intraventricular hemorrhage, and blood pressure at admission.
Numerous grading scales have been proposed to predict the outcome of aneurysmal subarachnoid hemorrhage SAH ; however, these have not been validated in angiogram-negative SAH patients. The predictive performance of the grading scales was assessed via evaluation of distribution, trend, association, and discrimination. Both grading scales indicated a significant trend between scores and outcome , and association with the outcome. However, the mFS performed with increased accuracy when predicting mRS However, angiogram-negative SAH still has a definite incidence of delayed cerebral ischemia DCI and poor outcome, particularly in patients with a nonperimesencephalic bleeding pattern [ 1 ]. However, none of these were initially designed for use in angiogram-negative SAH patients. These grading scales were derived and validated in the aneurysmal SAH patients but were also commonly used in the clinical assessment and prognosis of angiogram-negative SAH patients.
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Hunt & Hess Scale (Choose single most appropriate grade.) Description. Grade. Asymptomatic, mild headache, slight nuchal rigidity. 1. Moderate to severe.Reply