Lindvall Peter, Runnerstam Magnus, Birgander Richard, Koskinen Lars-Owe D
Department of Neurosurgery, Umeå University Hospital, Umeå, Sweden.
Br J Neurosurg. 2009 Apr;23(2):188-92. doi: 10.1080/02688690802710668.
Cerebral vasospasm is the major cause of delayed ischemia in patients with subarachnoid haemorrhage (SAH). The Fisher grading scale has been used to predict patients in risk of developing vasospasm. Improved radiological techniques and treatment may have changed the relevance of the Fisher scale. We have now evaluated the Fisher scale, Hunt and Hess and age in relation to outcome in patients with SAH. Eighty- three patients were admitted with SAH during two years, and 84 aneurysms were treated in 78 patients. The Glasgow outcome score (GOS) within 3 months were as follows; GOS 1 (19%), GOS 2 (2%), GOS 3 (11%), GOS 4 (9%), GOS 5 (59%). There was a significant correlation between both the Fisher grading scale, Hunt and Hess scale and outcome. Age was not correlated to the Fisher grading scale or the Hunt and Hess scale. Age was also not correlated to outcome in our patients. Despite the correlation to outcome both Hunt and Hess and the Fisher grading scale had a limited predictive value of outcome due to a low specificity and/or sensitivity.
脑血管痉挛是蛛网膜下腔出血（SAH）患者迟发性缺血的主要原因。Fisher分级量表已被用于预测发生血管痉挛风险的患者。改进的放射学技术和治疗方法可能改变了Fisher量表的相关性。我们现在评估了Fisher量表、Hunt和Hess分级以及年龄与SAH患者预后的关系。两年内有83例SAH患者入院，78例患者的84个动脉瘤得到治疗。3个月内的格拉斯哥预后评分（GOS）如下：GOS 1（19%），GOS 2（2%），GOS 3（11%），GOS 4（9%），GOS 5（59%）。Fisher分级量表、Hunt和Hess分级与预后之间均存在显著相关性。年龄与Fisher分级量表或Hunt和Hess分级均无相关性。在我们的患者中，年龄与预后也无相关性。尽管Hunt和Hess分级以及Fisher分级量表与预后存在相关性，但由于特异性和/或敏感性较低，它们对预后的预测价值有限。
