modified_fisher_scale [Operative Neurosurgery]

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====== Modified Fisher scale ======

{{::modifiedfisherscale.jpg|}}

**For prediction of Symptomatic vasospasm**

Scoring system

Abbreviations
SAH: subarachnoidal hemorrhage
IVH: intraventricular hemorrhage

**Diffuse thick SAH**

IVH: 4 points

No IVH: 3 points

**Localized thick SAH**

IVH: 4 points

No IVH: 3 points

**Diffuse thin SAH**

IVH: 2 points

No IVH: 1 points

**Localized thin SAH**

IVH: 2 points

No IVH: 1 points

**No SAH**

IVH: 2 points

No IVH: 0 points


Prediction of symptomatic vasospasm

1 point: 24%

2 points: 33%

3 points: 33%

4 points: 40%

((Frontera JA, Claassen J, Schmidt JM, Wartenberg KE, Temes R, Connolly ES, et al. Prediction of symptomatic vasospasm after subarachnoid hemorrhage: the modified fisher scale. Neurosurgery. 2006 Jul;59(1):21-7.)).

Additional intracerebral hemorrhage (ICH) was associated with an increased risk of [[delayed cerebral ischemia]] (DCI). Furthermore, adding the presence or absence of ICH to the [[modified Fisher Scale]] (mFS) improved the identification of patients at the highest risk for the development of DCI. Thus, a simple adjustment of the mFS might help to identify patients at high risk for DCI
((Platz J, Güresir E, Wagner M, Seifert V, Konczalla J. Increased risk of
delayed cerebral ischemia in subarachnoid hemorrhage patients with additional
intracerebral hematoma. J Neurosurg. 2016 Mar 11:1-7. [Epub ahead of print]
PubMed PMID: 26967776.
)).
----
The mFS and the modified Graeb score (mGS) have similar prognostic utility. Accounting for IVH volume improved prediction of Delayed cerebral ischemia (DCI) by the mFS
((Eagles ME, Jaja BNR, Macdonald RL. Incorporating a Modified Graeb Score to the
Modified Fisher Scale for Improved Risk Prediction of Delayed Cerebral Ischemia
Following Aneurysmal Subarachnoid Hemorrhage. Neurosurgery. 2017 Apr 17. doi:
10.1093/neuros/nyx165. [Epub ahead of print] PubMed PMID: 28419304.
)).