A summary of common grading systems used in neurosurgical practice

Background: Grading and scoring systems are routinely used across various specialties in medicine and surgery. They help us assess the severity of disease and often guide management as well. In addition, grading systems allow us to prognosticate and gauge outcomes. Neurosurgeons also utilize an array of scores and grading systems. This article aims to collate some of the common grading systems used in neurosurgical practice to be utilized as an easy reference especially for junior doctors and other health-care providers working in this field. Methods: An initial literature search was carried out to look at the grading systems in use. These were then distilled down to the ones that are frequently used in clinical neurosurgical practice based on my own experience as a doctor working in a tertiary neurosurgical unit. Neuro-oncology scoring systems were excluded from the study. Results: Grading systems are grouped based on the area of neurosurgical practice they fall into such as cranial, vascular, spinal, and miscellaneous. A brief description of each grading system is provided and the conditions when they can be used in a tabular format. Discussion on the advantages and disadvantages of each grading system is not included in the study. Conclusion: The list of grading systems in this article is not exhaustive. To the best of my knowledge, there seems to be no recent article, which summarizes them concisely. I hope that this summary will benefit the neurosurgical community and wider audience.