Highly cited scores, scoring systems, grading systems, and classifications of daily use in cranial neurosurgery: A must-have during residency training! A mini-review

Abstract

Context

Neurosurgery has much evolved since the time of Kocher and Cushing. Thanks to operative microscope, radiation therapy, progress of neuroresuscitation care, and data from evidence-based neurosurgical research, neurosurgery patients’ prognostic has improved. Now more than ever, we need simple, reliable, and reproducible scores, grades, and classifications to assist us in the surgical decision making, to assess patients’ clinical evolution, and to conduct proper neurosurgical research.

Materials and methods

We conducted a three stage scoping review: (1) identification of sections of interest: brain trauma, tumor, vascular, infection, stroke, functional outcome (2) identification of the most common diseases within each section, (3) we retained every score, scale, classification that is internationally recognized and/or highly cited and/or used daily in clinical practice or research setting and/or that is currently used by the author.

Results

23 scores were retained. Brain trauma section: Glasgow coma scale (1974), Glasgow Liège scale (1982), SHE score (2019), RASH score (2022). Tumor section: Karnofsky Performance status (1948), Graded Prognostic Assessment (2008), Simpson grade (1957), Sindou grade (2006), House and Brackmann (1983), Koos grade (1993), Knosp scale (1993). Vascular section: PHASES score (2014), UIATS score (2015), Hunt and Hess scale (1968), Fisher scale (1980), WFNS scale (1988), Spetzler Martin scale (1986), Borden scale (1995), Cognard scale (1995), Zabramski scale (1995). Stroke section: ICH score (2001), NIHSS (1989). Functional outcome section: Rankin scale (1957).

Conclusion

We provide a non-exhaustive list of 23 reference scales, scores, and classifications that can be safely used for cranial neurosurgery clinical practice and research.