WFNS grading system

Last revised by Assoc Prof Craig Hacking on 09 Nov 2020

The WFNS (World Federation of Neurosurgical Societies) grading system uses the Glasgow Coma Scale and presence of focal neurological deficits to grade the clinical severity of subarachnoid hemorrhage. This grading system was proposed in 1988, and this is one of the accepted systems (although not considered the best) at the time of writing (August 2016).


  • grade 1: GCS 15, no motor deficit.
  • grade 2: GCS 13-14 without deficit
  • grade 3: GCS 13-14 with focal neurological deficit
  • grade 4: GCS 7-12, with or without deficit.
  • grade 5: GCS <7 , with or without deficit.

The presence or absence of a focal neurological deficit is used to distinguish between grades 2 and 3.

The scale reflects that the biggest determinant of mortality is conscious state, whilst the predictor of morbidity is the presence of hemiparesis or aphasia 4.

See also

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