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World Federation of Neurological Surgeons (WFNS)
Grading System for Subarachnoid Hemorrhage scale
(click
here
for .pdf version)
Overview :
The
clinical grading system proposed by the World Federation of
Neurologic Surgeons is intended to be a simple, reliable and
clinically valid way to grade a patient with subarachnoid
hemorrhage. This system offers less interobserver variability
than some of the earlier classification systems.
|
Glasgow
Coma Score
|
Motor Deficit
|
Grade
|
|
15
|
absent
|
1
|
|
13 - 14
|
absent
|
2
|
|
13 - 14
|
present
|
3
|
|
7 - 12
|
present or absent
|
4
|
|
3 - 6
|
present or absent
|
5
|
*Where
a motor deficit refers to a major focal deficit.
Interpretation:
• Maximum score
of 15 has the best prognosis
• Minimum score
of 3 has the worst prognosis
• Scores of 8
or above have a good chance for recovery
• Scores of 3-5
are potentially fatal, especially if accompanied by fixed pupils
or absent oculovestibular responses
• Young
children may be nonverbal, requiring a modification of the coma
scale for evaluation
In
assessing outcome of subarachnoid hemorrhage, the Federation
recommended use of the Glasgow Coma Scale:
Glasgow coma scale
= (score for eye
opening) + (score for best verbal response) + (score for best
motor response)
Eye
Opening
Score
Spontaneously
4
To verbal
stimuli
3
To pain
2
Never
1
Best
Verbal Response
Score
Oriented
and converses
5
Disoriented and
converses
4
Inappropriate
words
3
Incomprehensible sounds
2
No response
1
Best
Motor Response
Score
Obeys
commands
6
Localizes pain 5
Flexion
withdrawal
4
Abnormal
flexion (discorticate rigidity)
3
Extension (decerebrate
rigidity)
2
No response
1
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