Jabbarli et al reported the CHESS for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage. The authors are from University Hospital Essen in Germany.
CHESS stands for Chronic Hydrocephalus Ensuring from SAH Score
Patient selection: aneurysmal subarachnoid hemorrhage
Outcome: shunt dependency
Parameters:
(1) Hunt & Hess grade
(2) location of the ruptured aneurysm
(3) intraventricular hemorrhage
(4) early cerebral infarction in follow-up CT scan
(5) acute hydrocephalus
Parameter
Finding
Points
Hunt & Hess grade
I to III
0
IV or V
1
location
posterior circulation
other
intraventricular hemorrhage
no
yes
early cerebral infarction
acute hydrocephalus
4
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 6 was associated with a high rate of shunt dependency.
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