[The clinical grading of subarachnoid hemorrhage].
Clinical grading scales for subarachnoid haemorrhages are exposed and discussed. These have been introduced by Botterell, in the middle fifties, to allow a better clinical evaluation, a more correct prognosis and, as a consequence, a more effective therapy. The most popular grading scale is, up to now, the one proposed by Hunt and Hess in 1968. The H-H scale divides patients in 5 groups or levels, whose severity is progressively increasing. A clinical study based on the H-H scale demonstrated that low grade patients (I-II) take advantage from early surgery; at the opposite, high grade patients (III-IV-V) achieve better results when treated with late surgery. To leave behind several difficulties in interpreting the clinical signs and therefore in using the H-H scale, in 1988 Drake, on behalf of the World Federation of Neuro-logical Surgeons, published an "universal" grading scale for subarachnoid haemorrhage, based upon the well known Glasgow Come Scale score and on the finding of a motor focal deficit. The WFNS Scale is nowadays recommended for universal use, being easy and compatible with formerly employed scales.
Clinica di Neurochirurgia, Ancona.
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Ducati
D006801:Humans; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology
Il grading clinico delle emorragie subaracnoidee.