How are cerebral aneurysms staged?

Updated: Dec 06, 2018
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Table 1. Clinical Condition at Presentation (Open Table in a new window)

Grade

Clinical Condition at Presentation

0

Unruptured aneurysm

1

Asymptomatic or minimal headache and slight nuchal rigidity

2

Moderately severe or severe headache and nuchal rigidity; cranial neuropathy, no focal deficit

3

Drowsiness, confusion, or mild focal deficit

4

Stupor, moderate to severe hemiparesis

5

Deep coma, decerebrate posturing, moribund appearance

 

Table 2. World Federation of Neurological Surgeons Scale (Open Table in a new window)

Grade

Glasgow Coma Scale Score

Clinical Findings

I

15

No headache or focal signs

II

15

Headache, nuchal rigidity, no focal signs

III

13-14

Headache, nuchal rigidity, no focal signs

IV

7-12

Headache, rigidity, focal signs

V

3-6

Headache, rigidity, focal signs

 

Table 3. Fisher Grade (Open Table in a new window)

Grade

CT Findings

1

No blood detected

2

Diffuse thin layer of subarachnoid blood

3

Localized thrombus or thick layer of subarachnoid blood

4

Intracerebral or intraventricular hemorrhage with diffuse or no subarachnoid blood


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