Abstract
A new clinical grading system (CEMC-grading) and a scoring system of CT-findings for ruptured intracranial aneurysm have been employed prospectively in Chiba Emergency Medical Center since April, 1980.
This CEMC grading system is a modification of that of Hunt and Hess, and patients are classified according to their Glasgow Coma Scale. Scoring system of CT findings consists of three factors that determine severity of ruptured aneurysm, these are; volume of SAH, existence of ICH and the extent of IVH. As index of blood volume in subarachnoid space, Hounsfield number was measured in 6 cisterns. Zero to 4 points are assigned to specific ranges of Hounsfield number. Total points in 6 cisterns are determined as SAH-score. As for ICH, 0 to 4 points were assigned, and concerning IVH, 0 to 2 points were assigned. Total points of 3 categories is called CT-score of ruptured aneurysm.
Three hundred and thirty-six cases with ruptured aneurysms in the anterior circulation arrived within 72 hours of attack were analyzed using these CEMC-grading and scoring system of CT-findings.
The CEMC-grading as well as the CT-score of ruptured aneurysm were well correlated with the outcome of patients.
And differences in SAH-score were significant between a group with symtomatic vasospasm and a group without symptomatic vasospasm.
This new clinical grading system and a scoring system of CT-findings for ruptured aneurysm were of value as to treat ruptured aneurysm especially in acute stage.
