Modified Fisher scale
Updates to Article Attributes
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was changed:
The modified Fisher scale is a method for grading subarachnoid haemorrhage (SAH) seen on CT. It was developed from the original Fisher scale which was modified to account for patients with thick cisternal blood and concomitant intraventricular (IVH) or intraparenchymal haemorrhage.
Moreover, the risk of developing vasospasm progressively increases with each level of the modified Fisher grade. Whereas the risk was highest for Grade 3 and then decreased for Grade 4 while using the original Fisher scale.
Classification
-
grade 0
- no subarachnoid haemorrhage (SAH)
- no intraventricular haemorrhage (IVH)
-
incidence of symptomatic vasospasm:
no SAH or IVH0% 3
-
grade 1
:-
focal or diffuse, thin SAH
, - no IVH
- incidence of symptomatic vasospasm: 24%
:-
thin focal or diffuse
, thinSAH, with IVH - IVH present
- incidence of symptomatic vasospasm: 33%
-
focal or diffuse, thin SAH
-
grade 3
:-
thick focal or diffuse
, thickSAH, - no IVH
- incidence of symptomatic vasospasm: 33%
-
thick focal or diffuse
-
grade 4
:-
thick focal or diffuse
, thickSAH, with IVH - IVH present
- incidence of symptomatic vasospasm: 30%
-
thick focal or diffuse
Note: thin SAH is < 1mm thick and thick SAH is >1 mm in depth.
-<strong>grade 0</strong>: no SAH or IVH</li>- +<strong>grade 0</strong><ul>
-<strong>grade 1</strong>: focal or diffuse, thin SAH, no IVH</li>- +<strong></strong>no subarachnoid haemorrhage (SAH)</li>
- +<li>no intraventricular haemorrhage (IVH)</li>
- +<li>incidence of symptomatic vasospasm: 0% <sup>3</sup>
- +</li>
- +</ul>
- +</li>
-<strong>grade 2</strong>: focal or diffuse, thin SAH, with IVH</li>- +<strong>grade 1</strong><ul>
-<strong>grade 3</strong>: focal or diffuse, thick SAH, no IVH</li>- +<strong></strong>focal or diffuse, thin SAH</li>
- +<li>no IVH</li>
- +<li>incidence of symptomatic vasospasm: 24%</li>
- +</ul>
- +<strong>grade 2</strong><ul>
-<strong>grade 4</strong>: focal or diffuse, thick SAH, with IVH</li>-</ul><p>Note: thin SAH is < 1mm thick and thick SAH is >1 mm in depth. </p>- +<strong></strong>thin focal or diffuse SAH</li>
- +<li>IVH present</li>
- +<li>incidence of symptomatic vasospasm: 33%</li>
- +</ul>
- +</li>
- +<li>
- +<strong>grade 3</strong><ul>
- +<li>thick <strong></strong>focal or diffuse SAH</li>
- +<li>no IVH</li>
- +<li>incidence of symptomatic vasospasm: 33%</li>
- +</ul>
- +</li>
- +<li>
- +<strong>grade 4</strong><ul>
- +<li>thick <strong></strong>focal or diffuse SAH</li>
- +<li>IVH present</li>
- +<li>incidence of symptomatic vasospasm: 30%</li>
- +</ul>
- +</li>
- +</ul><p> </p><p>Note: thin SAH is < 1mm thick and thick SAH is >1 mm in depth. </p>
References changed:
- 3. Frontera JA. Decision Making in Neurocritical Care. Thieme. (2011) ISBN:1604061634. <a href="http://books.google.com/books?vid=ISBN1604061634">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1604061634">Find it at Amazon</a><span class="auto"></span>
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