What is the Hunt-Hess scale?

The Hunt-Hess scale, published in 1968 by W.E. Hunt and R.M. Hess, is a five-grade clinical classification system for subarachnoid hemorrhage. Grade I represents a mild headache with minimal symptoms; Grade V represents deep coma with decerebrate posturing.

How does Hunt-Hess differ from the WFNS SAH scale?

The World Federation of Neurological Surgeons (WFNS) scale uses the Glasgow Coma Scale (GCS) score plus the presence of a focal motor deficit, making it more objective and reproducible. Hunt-Hess relies on clinical assessment of headache severity, neck stiffness, mental status, and focal deficits.

Are the mortality figures exact?

No. The mortality ranges shown are approximate estimates derived from published literature. Actual outcomes depend on aneurysm characteristics, patient age, comorbidities, time to treatment, and institutional experience. Use this tool for orientation and education, not definitive prognostication.

Should I use Hunt-Hess for non-aneurysmal SAH?

The scale was developed for aneurysmal SAH. It is commonly applied to all spontaneous SAH presentations for initial grading, but prognostic accuracy for perimesencephalic or traumatic SAH may be lower.

Hunt-Hess Subarachnoid Hemorrhage Scale

Name: Hunt-Hess Subarachnoid Hemorrhage Scale
Availability: InStock
Author: Nham Vu

Select clinical findings to assign a Hunt-Hess grade (I-V) for subarachnoid hemorrhage with associated mortality risk and management guidance.

Select Clinical Grade

Choose the single grade that best describes the patient's current presentation.

Add +1 grade modifier

Serious systemic disease (e.g., hypertension, diabetes, severe atherosclerosis) or severe vasospasm on angiography

Select a grade on the left

Results and guidance will appear here.

Summary

Select clinical findings to assign a Hunt-Hess grade (I-V) for subarachnoid hemorrhage with associated mortality risk and management guidance.

How it works

Review the patient's presenting neurological status.
Select the single best-fit grade description from the five options listed.
The tool highlights the matched grade and displays its key features.
Review the estimated 30-day mortality range and typical management approach.
Use the result to guide neurosurgical consultation and treatment planning.

Use cases

Rapid bedside grading of aneurysmal subarachnoid hemorrhage.
Standardizing SAH severity documentation across care teams.
Estimating prognosis and communicating risk to families.
Triaging patients for early neurosurgical intervention.
Medical education and case-based learning for neurology and emergency medicine.
Research and quality improvement data collection for SAH outcomes.

Frequently Asked Questions

Last updated: 2026-06-11 · Reviewed by Nham Vu