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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109

Volume 12, Issue 1, September 2014 pp 177-181

Research Article

Correlation of revised fisher scale with clinical grading (WFNS) in patients with non-traumatic subarachnoid haemorrhage

Basti Ram S.1, Kumbar Vishwanath G.2, Nayak Madhukar T.3, Xavier Joseph V.4

{1Assistant Professor, 2Junior Resident, 4Senior Resident} {3Associate Professor, Department of Neurosurgery}

Department of Radio diagnosis, Father Muller Medical College, Mangalore, Karnataka, INDIA.

Aneurysmal Subarachnoid hemorrhage (aSAH) is the collection of blood in subarachnoid spaces, caused by ruptured intracranial aneurysm. It presents with a wide range of clinical symptoms and final outcomes. The patient factors, pathology involved, the time and treatment rendered all affects the final outcome of the patient. The final outcome of aSAH can be predicted at the time of admission. Factors used to predict the outcome are neurological grade on admission (World Federation of Neurosurgeons (WFNS) grading), amount of blood on early computed tomography (CT) (revised Fisher Scale- RFS), angiographic vasospasm and re-bleeding. Other factors such as age, sex, pre-existing medical diseases, aneurysm size and location; however there is inconclusive evidence of their effect on the outcome. The purpose of our study was to evaluate the role of RFS in predicting the final clinical outcome and assess the correlation of RFS with WFNS scale at the time of presentation and at discharge. A total of 55 patients were analyzed retrospectively. Their medical history and neurological assessment, according to WFNS grading at the time of admission and discharge were recorded. The radiological findings seen on CT brain and angiography (particularly the amount of SAH, the number, size, and location of the aneurysm) were recorded. The amount of SAH (RFS) and WFNS grade at admission and discharge were correlated with the outcome using Fishers exact test. Unfavourable outcome was associated with increasing age, worsening neurological grade, more SAH on admission CT, intracerebral or intraventricular hemorrhage. In our study there is significant correlation (P= 0.001) was noted between WFNS grade and RFS at the time of admission and at the time of discharge from the hospital. Out of 55 patients, 43 patients (78.1%) had good outcome and 12 patients (21.8%) had unsatisfactory outcome, 7 of them died (13%).