Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 4)
The Fisher Grade in predicting a degree of cerebral vasospasm in patients after intracranial aneurysm rupture
Authors:
Djula Djilvesi, Tomislav Cigić, Vladimir Papić, Igor Horvat, Mladen Karan, Petar Vuleković
Background/Aim. Intracranial aneurysms are pathologicalenlargement of the wall of cerebral arteries. Intracranial aneurysms
rupture is a dramatic event with a significant morbidity
and mortality. The Fisher Grade is widely accepted in
assessment of the extensiveness of aneurysmal subarachnoid
hemorrhage (aSAH) and the presence of other intracranial
hemorrhage on the computed tomography (CT) scan.
Significant early complication of a aSAH may be a cerebral
vasospasm. The aim of this study was to determine the relationship
between the extensiveness of aSAH, assessed by
the Fisher Grade on admission, with the intensity of cerebral
vasospasm in patients with ruptured intracranial aneurysm.
Methods. This prospective clinical study included 50
patients with aSAH hospitalized at the Clinic of Neurosurgery,
Clinical Center of Vojvodina, Novi Sad, Serbia. All the
patients underwent 256-layer cranial CT and CT angiography
on admission and on the day 9. Based on native CT
scans, they were classified according to the Fisher Grade.
On CT angiography images, intensity of cerebral vasospasm
was determined. Results. On the basis of admission CT
images, 24% of patients were classified into the Fisher
Grade group 2, while 34% and 42% were in the groups 3
and 4, respectively. A positive correlation of the Fischer
Grade on admission with the intensity of cerebral vasospasm
was established, but with no statistical significance (ρ
= 0.273, p = 0.160). Conclusion. This study showed that
the Fisher Grade is not significant in predicting the intensity
of cerebral vasospasm in patients hospitalized with intracranial
aneurysm rupture.
