Fisher revised scale for assessment of prognosis in patients with subarachnoid hemorrhage.
The Fisher revised scale (FRS) presents an alternative for evaluating patients with subarachnoid hemorrhage (SAH). In this study, we compared the prognosis of patients with SAH and vasospasms (VSP).


METHODS
This was a prospective study on patients with a diagnosis of aneurysmal SAH, 72 hours after the initial event. Sequential neurological examinations and Hunt and Hess (HaH) score were performed on the 1(st), 7(th) and 14(th) days. Transcranial Doppler was used to assess vasospasms.


RESULTS
Out of the 24 patients studied, ten (41.66%) presented a delayed neurological deficit, such as diminished consciousness, decreased HaH score or death. The single patient classified as FS-1 did not have any delayed neurological deficit, while such deficits evolved in one patient out of five with FS-2 (20%); two out of seven with FS-3 (28.57%) and seven out of 11 with FS-4 (63.63%).


CONCLUSIONS
Level three of the FS and FRS seemed to be compatible with regard to predicting the likelihood of progression to severe VSP.
Department of Neurology, Division of Neurosurgery, Hospital das Clínicas, University of São Paulo Medical School, Brazil.
Arthur Maynart Pereira
AM
Oliveira
Wellingson Silva
WS
Paiva
Eberval Gadelha de
EG
Figueiredo
Helio Araujo
HA
Oliveira
Manoel Jacobsen
MJ
Teixeira
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*