Neurovista

Grand Rounds will resume December 5th with the North Neurosurgery Report by Dr. Jonathan Brisman, North Attending.  Dr. Brisman will soon be leaving the MGH to receive endovascular fellowship training with Dr. Alex Berenstein  in New York City.  This will represent a homecoming for Dr. Brisman whose father Dr. Ronald Brisman is a neurologic surgeon at Columbia University and brother Dr. Michael Brisman who practices neurosurgery on Long Island.

The MGH aneurysm grade is based on 5 admission factors in a patient with an intracranial aneurysm.  One point is given for each of the following factors:

• Age>50
• Size>10 mm
• Fisher Score of 3 or 4  (dense SAH or ICH)
• Hunt-Hess Score of 4 or 5 (patient is comatose)
• Giant Posterior Circulation lesion

For example, a 70 year old patient with an unruptured 13 mm anterior communicating artery aneurysm would have a score of 2 with a 20% chance of major disability according to the scale.

A 37 year old with a ruptured 6 mm PICA aneurysm with a Hunt-Hess score of 1 and Fisher score of 3 would obtain a score would have an MGH score of 1 with an expected very good outcome.

A 54 year old with an unruptured 5 mm posterior communicating aneurysm would have an MGH score of 1 with an expected excellent outcome.

Development of the grading system is described here and the PubMed citation is here.

This is a test.