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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(04): 279-283
DOI: 10.1055/s-0037-1606632
Review Article | Artigo de Revisão

Fisher Grading Scale and Cognitive Deficits — Literature Review

Escala de Fisher e déficits cognitivos — Revisão da literatura
Moysés L. Ponte Souza 
1   Universidade de Pernanbuco, Recife, PE, Brazil
2   Hospital da Restauração, Recife, PE, Brazil
,
Ana C. Vieira
2   Hospital da Restauração, Recife, PE, Brazil
,
Hildo R.C. Azevedo-Filho
1   Universidade de Pernanbuco, Recife, PE, Brazil
2   Hospital da Restauração, Recife, PE, Brazil
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Abstract

Subarachnoid hemorrhage (SAH) accounts for 5 to 10% of all types of stroke, with rupture of brain aneurysms being related to deficits in memory, executive functions, and language. Changes in brain functions appear to be related to the presence of blood in the subarachnoid space, and the Fisher Scale (FS) correlates the amount of blood identified on computed tomography (CT). This paper presents a literature review of the association of FS with cognitive deficits secondary to aneurysmal subarachnoid hemorrhage (aSAH), using PubMed. The attempt to correlate the amount of blood identified in the CT with the development of cognitive alterations presents conflicting data. It was evidenced that some of the studies did not perform cognitive tests, or did not show differences between the scores of FS due to sample difficulty. The FS, even with its limitations and imperfections, seems to be a safe and easily reproducible way to predict neurological, cognitive or neuropsychological deficits, in view of its routine use when analyzing patients with aSAH.

Resumo

Hemorragia subaracnóidea (HSA) representa de 5 a 10% de todos os tipos de acidente vascular encefálico, estando a ruptura de aneurismas cerebrais relacionada a déficits na memória, nas funções executivas e na linguagem. As alterações nas funções cerebrais parecem estar relacionadas à presença de sangue no espaço subaracnóideo, sendo a escala de Fisher (EF) a forma de mensuração do conteúdo hemático, realizada através de tomografia computadorizada (TC). O presente artigo apresenta uma revisão da literatura sobre a associação da EF com déficits cognitivos secundários a HSA aneurismática (HSAa), tendo como banco de dados para a pesquisa o PubMed. A tentativa de correlacionar a quantidade de sangue identificada na TC de crânio com o desenvolvimento de alterações cognitivas apresenta dados bastante conflitantes, evidenciando que alguns dos trabalhos não realizaram testes cognitivos, ou não demonstraram diferenças entre os graus da EF por dificuldade na amostragem. A EF, mesmo com suas limitações e imperfeições, parece ser uma forma segura e de fácil reprodutibilidade para predizer déficits neurológicos, cognitivos ou neuropsicológicos, tendo em vista o seu uso rotineiro na análise de pacientes com HSAa.

Keywords

intracranial aneurysm - cognitive dysfunction - subarachnoid hemorrhage - tomography

Palavras-chave

aneurisma intracraniano - disfunção cognitiva - hemorragia subaracnóidea - tomografia


Publication History

Received: 26 June 2017

Accepted: 24 August 2017

Article published online:
13 September 2017

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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