{"id":"5c7daf3a-2b92-48f0-9d08-29e7ff45e6c9","slug":"modified-world-federation-of-neurosurgical-societies-subarachnoid-hemorrhage-grading-system","title":"Modified world federation of neurosurgical societies subarachnoid hemorrhage grading system","authors":["Hirotoshi Sano","Joji Inamasu","Yoko Kato","Akira Satoh","Yuichi Murayama"],"abstract":"Background: The World Federation of Neurosurgical Societies (WFNS) scale for grading patients with aneurysmal subarachnoid hemorrhage (SAH) has been widely accepted since its publication in 1988. The original WFNS scale utilizes the Glasgow Coma Scale (GCS) score and the presence of focal neurologic deficits for classification. However, inter-rater variability has been noted due to ambiguities in identifying neurologic deficits. Summary: A modified WFNS scale (m-WFNS) has been proposed to enhance prognostic accuracy by classifying patients with a GCS score of 14 into grade II and those with a score of 13 into grade III, regardless of neurologic deficits. A multicenter study involving 1656 aneurysmal SAH patients demonstrated that the m-WFNS scale showed superior outcome predictability compared to the original scale, particularly at discharge. Conclusion: The m-WFNS scale may provide a simpler and more reliable method for prognostication in SAH patients. Although the study was limited to Japanese neurosurgeons, there is hope for broader adoption and validation of the m-WFNS scale internationally. Keywords: subarachnoid hemorrhage, WFNS scale, prognostication, Glasgow Coma Scale, neurologic deficits, outcome predictability, neurosurgery","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/5c7daf3a-2b92-48f0-9d08-29e7ff45e6c9/featured/hero-1782420924501.png","publishDate":"2016-08-01T00:00:00.000Z","doi":"10.4103/2152-7806.187491","categories":["Neurovascular","Letter to the Editor"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2016/08/7843/SNI-7-502.pdf"}