Home › Neurology › WFNS

WFNS Grade for Subarachnoid Hemorrhage

The WFNS scale grades aneurysmal subarachnoid haemorrhage I–V from the GCS and presence of a major focal motor deficit: I = GCS 15; II = GCS 13–14 without deficit; III = GCS 13–14 with deficit; IV = GCS 7–12; V = GCS 3–6. Grades IV–V are "poor grade".

Glasgow Coma Scale
Major focal motor deficit (hemiparesis/aphasia) (yes/no, +1)

—

Interpretation

Result	Meaning
I	GCS 15, no motor deficit
II	GCS 13–14, no motor deficit
III	GCS 13–14, motor deficit
IV	GCS 7–12, ± deficit
V	GCS 3–6, ± deficit

Formula

Grade I: GCS 15 · II: GCS 13–14, no major motor deficit · III: GCS 13–14 with deficit · IV: GCS 7–12 · V: GCS 3–6

Clinical pearls

Grade after resuscitation (and after treating hydrocephalus or seizures where possible); pre-resuscitation grades overestimate severity.
Motor deficit only discriminates between grades II and III.

Examples

wfns gcs 14 no motor deficit SAH grade for a patient with GCS 10 and right hemiparesis

FAQ

What is poor-grade SAH?

WFNS grade IV–V (GCS ≤12) is conventionally called poor grade.

WFNS vs Hunt-Hess: which should I use?

WFNS is based on GCS and has better inter-rater reliability; Hunt-Hess is descriptive. Many centres document both.

Evidence

Report of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg 1988;68:985–6.

Neurology · Reviewed 2026-10-14 · Methodology