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Updated: Jul 20, 2026
A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
Published on: January 17, 2013
The post-resuscitation VASOGRADE: a more accurate scale to predict delayed cerebral ischemia after aneurysmal
Thomas Ritzenthaler1, Florent Gobert2, Baptiste Balança2,3
1Service de Réanimation Neurologique, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France. thomas.ritzenthaler@chu-lyon.fr.
Background:
Predicting the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage is of interest to adjust the level of care. The VASOGRADE, a simple grading scale using admission World Federation of Neurosurgical Societies (WFNS) grading score and modified Fisher scale (mFS) on first CT scan, could help to select patients at risk of DCI. However, using data after initial resuscitation (initial complication treatment, aneurysm exclusion) may be more relevant.
Methods:
We calculated a post-resuscitation VASOGRADE (prVG) using WFNS grade and mFS after early brain injury treatment and aneurysm exclusion (or at day 3). Patients were categorized as green, yellow, or red.
Results:
Using our prospective observational registry, 566 patients were included in the study. Two hundred six (36.4%) were classified as green, 208 (36.7%) as yellow, and 152 (26.9%) as red, and DCI was experienced in 22 (10.7%), 67 (32.2%), and 45 (29.6%) cases respectively. Patients classified as yellow had higher risk of developing DCI (OR 3.94, 95% CI 2.35-6.83). Risk was slightly lower in red patients (OR 3.49, 95% CI 2.00-6.24). The AUC for prediction was higher with prVG (0.62, 95% CI 0.58-0.67) than with VASOGRADE (0.56, 95% CI 0.51-0.60) (p < 0.01).
Conclusion:
By using simple clinical and radiological scale evaluated at subacute stage, prVG is more accurate to predict the occurrence of DCI.
