Ogilvy and Carter developed a grading system for use in a patient with an intracranial aneurysm. The system can help separate patients into prognostic groups with different outcomes. The authors are from Massachusetts General Hospital and Harvard Medical School in Boston.
Parameters:
(1) age of the patient in years
(2) grade of Hunt and Hess for subarchnoid hemorrhage
(3) Fisher scale score for subarachnoid hemorrhage
(4) diameter of the aneurysm in mm
(5) giant lesion in the posterior circulation (>= 25 mm in diameter)
Parameter
Finding
Points
age of the patient
<= 50 years of age
0
> 50 years of age
1
grade of Hunt and Hess
0 to III (absence of coma)
0
IV or V (presence of coma)
1
Fisher scale score
0, 1 or 2
0
3 or 4
1
diameter of the aneurysm
<= 10 mm
0
> 10 mm
1
giant lesion in the posterior circulation
absent
0
present
1
grade =
= SUM(points for the 5 parameters)
Interpretation:
• minimum grade: 0
• maximum grade: 5
• The higher the grade the higher the risk of mortality.
• The prognosis for Grades 0 and 1 is good.
• The prognosis for Grades 4 and 5 is poor (> 50% mortality).
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