Modified Fisher scale
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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 intraventricular haemorrhage (IVH)
- incidence of symptomatic vasospasm: 0% 3
-
-
grade 1
-
- no IVH
- incidence of symptomatic vasospasm: 24%
-
- IVH present
- incidence of symptomatic vasospasm: 33%
-
-
grade 3
- thick
focal or diffuse SAH - no IVH
- incidence of symptomatic vasospasm: 33%
- thick
-
grade 4
- thick
focal or diffuse SAH - IVH present
- incidence of symptomatic vasospasm: 30%
- thick
Note: thin SAH is < 1mm1 mm thick and thick SAH is >1 mm in depth.
-<li>-<strong></strong>no subarachnoid haemorrhage (SAH)</li>- +<li>no subarachnoid haemorrhage (SAH)</li>
-<li>-<strong></strong>focal or diffuse, thin SAH</li>- +<li>focal or diffuse, thin SAH</li>
-</ul>-<strong>grade 2</strong><ul>-<li>-<strong></strong>thin focal or diffuse SAH</li>- +</ul> <strong>grade 2</strong><ul>
- +<li>thin focal or diffuse SAH</li>
-<li>thick <strong></strong>focal or diffuse SAH</li>- +<li>thick <strong> </strong>focal or diffuse SAH</li>
-<li>thick <strong></strong>focal or diffuse SAH</li>- +<li>thick <strong> </strong>focal or diffuse SAH</li>
-</ul><p> </p><p>Note: thin SAH is < 1mm thick and thick SAH is >1 mm in depth. </p>- +</ul><p> </p><p>Note: thin SAH is < 1 mm thick and thick SAH is >1 mm in depth. </p>
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