Biology Reference
In-Depth Information
Table 2
The Glasgow coma score (GCS)
1
2
3
4
5
6
Eyes
No opening
Open to pain Open to voice Open
spontaneously
-
-
Verbal No sounds
Moaning
Inappropriate
words
Confused
speech
Oriented
and normal
conversing
-
Motor No movement Extension
posturing
Flexion
posturing
Flexion/
withdrawal
to painful
stimulation
Localizes
painful
stimulation
Follows
commands
Table 3
WFNS scale
WFNS grade
GCS score
Major focal defi cit
0 (Unruptured aneurysm)
N/A
N/A
1
15
2
13-14
3
13-14
+
4
7-12
+/−
5
3-6
+/−
Rosen et al. ( 15 ) reviewed the cases of 3,500 patients with
SAH who were prospectively graded and assessed for outcome.
Three months after SAH the GOS was scored and likelihood ratio
of a poor outcome for each individual score was: WFNS grade
1 = 0.36, WFNS grade 2 = 0.61, WFNS grade 3 = 1.78, WFNS
grade 4 = 2.47, and WFNS grade 5 = 5.22 ( 15 ).
Two thirds of patients fell into the WFNS grade 1 or 2 while
the remaining one third was about equally split between the other
three grades. With a large proportion of patients falling into the
best grades, drawing conclusions becomes diffi cult based on the
relatively small number of poor grade SAH included.
6. Fisher Grading
System for SAH
and Vasospasm
The Fisher grading scale (Table 4 ) relating to SAH was developed
not for outcome assessment but rather to determine risk for the
development of cerebral vasospasm ( 16 ). The Fisher grading scale
 
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