Neurosurgery

Intracerebral hemorrhage volume and prognosis

Intracerebral hemorrhage volume is calculated using the ABC/2 method, where A and B are the largest perpendicular dimensions and C is slice thickness multiplied by the number of slices with visible hemorrhage. Hematoma volume is the strongest predictor of 30-day mortality in spontaneous ICH, with volumes >30 mL associated with significantly worse outcomes.

Subarachnoid hemorrhage grading and vasospasm risk

Subarachnoid hemorrhage grading uses the Fisher scale (CT appearance), the modified Fisher scale, and the Hunt and Hess grading system (clinical severity). These scores predict vasospasm risk, delayed cerebral ischemia, and overall prognosis, guiding aneurysm treatment timing and ICU monitoring intensity.

Spinal instability and trauma classification

Spinal instability assessment in metastatic disease uses the Spine Instability Neoplastic Score (SINS), while traumatic spinal injury is classified using the TLICS (Thoracolumbar Injury Classification and Severity Score) and Subaxial Injury Classification (SLIC). These scores guide the decision between non-operative management, minimally invasive stabilization, and open surgical reconstruction.