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Subarachnoid hemorrhage grading scales

Robert J Singer, MD
Christopher S Ogilvy, MD
Guy Rordorf, MD
Section Editor
Jose Biller, MD, FACP, FAAN, FAHA
Deputy Editor
Janet L Wilterdink, MD


Subarachnoid hemorrhage (SAH) is often a devastating event. The appropriate therapy for SAH depends in part upon the severity of hemorrhage. Level of consciousness on admission, patient age, and the amount of blood on initial head computed tomography (CT) scan are the most important prognostic factors for SAH at presentation [1].

A number of grading systems are used in practice to standardize the clinical classification of patients with SAH based upon the initial neurologic examination and the appearance of blood on the initial head CT. This topic will provide an overview of the more commonly used clinical and radiologic grading scales for SAH. Treatment and other aspects of SAH are discussed separately. (See "Treatment of aneurysmal subarachnoid hemorrhage" and "Clinical manifestations and diagnosis of aneurysmal subarachnoid hemorrhage".)


An ideal SAH grading scale would provide the following capabilities [2-4]:

Guide management decisions that are influenced by the severity of SAH

Provide prognosis for clinicians, patients, and family members

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Literature review current through: Nov 2017. | This topic last updated: Jun 19, 2017.
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