Question

Which of the following grading methods is used to evaluate the prognosis or outcome after subarachnoid hemorrhage?

• A. Glasgow coma scale
• B. Hunt and Hess scale
• C. Glasgow-Blatchford bleeding score
• D. Intracerebral hemorrhage score

Hint:

Think of the SAH specific clinical grade that runs I to V.

Answer 1

The Correct Option is B

Step 1: Subarachnoid hemorrhage (SAH) means bleeding into the space between the arachnoid and pia mater, most often from a ruptured berry aneurysm. The clinical state on arrival predicts how the patient will do, so a dedicated grading scale is used.
Step 2: The Hunt and Hess scale grades SAH from I to V based on the clinical picture. Grade I is mild headache, Grade V is deep coma with decerebrate posturing. A higher grade means worse prognosis and higher surgical risk. This makes it the standard tool to predict outcome after SAH.
Step 3: Why the others are wrong. The Glasgow coma scale measures the depth of unconsciousness in general head injury and is not SAH specific, though it feeds into other scores. The Glasgow-Blatchford bleeding score is for upper gastrointestinal bleeding, not brain bleeds. The intracerebral hemorrhage (ICH) score predicts mortality in intraparenchymal brain bleeds, not subarachnoid bleeds.
Step 4: The dedicated prognostic grading scale for SAH is the Hunt and Hess scale.
Answer: Option B, Hunt and Hess scale.