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OBJECTIVE: We developed a modification of the Fisher computed tomographic (CT) rating scale and compared it to the original Fisher scale to determine which scale best predicts symptomatic vasospasm after subarachnoid hemorrhage (SAH).

METHODS: We analyzed data from 1355 SAH patients in the placebo-arm of four randomized, double-blind, placebo-controlled studies of tirilazad. Modified Fisher CT grades were calculated based the presence of cisternal blood and intraventricular hemorrhage. Crude odds ratios (OR) reflecting the risk of developing symptomatic vasospasm were calculated for each scale level, and adjusted ORs expressing the incremental risk were calculated after controlling for known predictors of vasospasm.

RESULTS: Of 1355 patients, 451 (33%) developed symptomatic vasospasm. For the modified Fisher scale, compared to Grade 0–1 patients, the crude OR for vasospasm was 1.6 …