Subject Information
1 Suprasellar Cistern (SSTV)
SSTV0.000 mL
2 Perimesencephalic Cistern (PMTV)
Right
Left
PMTV (R + L)0.000 mL
3 Prepontine Cistern (PPTV)
PPTV0.000 mL
4 Sylvian Cistern (SYTV)
Right
Left
SYTV (R + L)0.000 mL
5 Interhemispheric Fissure (ITV)
ITV0.000 mL
DCI Risk Assessment
SAHV >10 mL associated with higher risk of delayed cerebral ischemia (Freeman & Föttinger, JAHA 2024)
Enter measurements to assess
6 Intraparenchymal Hemorrhage (IPH) & Subdural Hematoma (SDH)
IPH
Right
Left
IPH Total0.000 mL
SDH (ABC/2 ÷ 2)
Right
Left
SDH Total0.000 mL
TOTAL SAHV — 5-Space Cisternal Volume
0.000 mL
6-Space Total (All + IPH/SDH)
0.000 mL
IPH + SDH Combined
0.000 mL
Clinical Notes
Note: The “8th Space” is defined as a gyral-sulcal space that is generally too small to contribute any significant volume (cm³).
The quadrigeminal cistern was not included in our measurements.
Anatomic Reference — SAHVAI 5 Cisternal Spaces + 2 Intra-Axial (IPH/ICH) + IVH Model
Click any image to enlarge. Images from Freeman & Föttinger ABC/2-derived SAHV method.
Anatomic Definitions of Cisternal Spaces
| Region | Definition |
|---|---|
| 1. Suprasellar cistern | Region around the cranial sella turcica, under the hypothalamus and between the uncus of the temporal lobes |
| 2. Perimesencephalic cistern | Region of the ambient cistern and crural cistern, extending in a crescent-shaped manner along the lateral aspect of the mesencephalon |
| 3. Prepontine cistern | Region extending ventrally over the most caudal segment to the most cranial part of pons |
| 4. Sylvian cisternal complex | Region of the Sylvian cistern containing the lateral projection of the suprasellar cistern (along the temporal pole), the cistern of lateral cerebral fossa and its occipital projection into the Sylvian fissure; anterior part sits between the fronto-orbital cortex and the temporal lobe |
| 5. Anterior interhemispheric cistern | Region cranioventral to suprasellar cistern, until leveled with frontal horn of lateral ventricle |
| 6. IPH | Intraparenchymal hemorrhage (IPH), or intracerebral hemorrhage (ICH) |
| 7. IVH / SDH / EDH | Intraventricular hemorrhage (IVH) is semi-quantitatively measured by modified Graeb, and/or subdural hematoma (SDH), or epidural hemorrhage (EDH) components are measured by a modified ABC/2 formula using maximal EDH/SDH thickness and length as A and B, and vertical dimensions as C (Freeman et al., Neurocrit Care 2008; PMID: 18392784) |
| 8. Gyral-sulcal SAH blood (not measured) | Generally too small to contribute significant volume; not included in the above 5-compartment SAHV ABC/2 model by Föttinger/Freeman et al. |
ABC/2-Derived Volume Formula
VSAH(mL) = (A × B × C × slice thickness) / 2 × 10−3
A = maximal length of SAH in the respective cisternal compartment (mm)
B = maximal thickness/width of SAH (mm)
C = number of vertical NCHCT slices with SAH × slice thickness (mm)
For bilateral structures (Perimesencephalic, Sylvian, IPH, SDH), right and left are measured independently and summed.
B = maximal thickness/width of SAH (mm)
C = number of vertical NCHCT slices with SAH × slice thickness (mm)
For bilateral structures (Perimesencephalic, Sylvian, IPH, SDH), right and left are measured independently and summed.
Key SAHVAI Publications
1. The ABCs of Subarachnoid Hemorrhage Blood Volume Measurement: A Simplified Quantitative Method Predicts Outcomes and Delayed Cerebral Ischemia
J Am Heart Assoc. 2024;13(20):e032195
DOI: 10.1161/JAHA.123.032195 • PMID: 39392139
Original ABC/2-derived SAHV method. Demonstrated comparability to manual segmentation (n=277). SAHV >10 mL cutoff predicts DCI and poor outcomes.
2. SAHVAI-3D and 4D: Automated AI Volumetric Measurement of Subarachnoid Hemorrhage on Noncontrast Head CT
Stroke Vasc Interv Neurol. 2025;5(3):e001620
DOI: 10.1161/SVIN.124.001620 • PMID: 41573412
AI automation of SAHV (SAHVAI). 6.7 seconds vs >60 min manual. 99.8% accuracy, Dice 0.701. 3D brain maps and 4D temporal tracking.
3. External Multicenter Validation of the eSAH Score for Predicting Outcomes After Subarachnoid Hemorrhage
Sci Rep. 2025;16(1):4218
DOI: 10.1038/s41598-025-34326-3 • PMID: 41476130
External validation of eSAH score (n=472) across US and Brazil centers. AUC 0.78 for unfavorable outcome, 0.799 for mortality. Each point = 2.14× odds of poor outcome.
4. The eSAH Score: A Simple Practical Predictive Model for SAH Mortality and Outcomes
Sci Rep. 2024;14(1):30753
DOI: 10.1038/s41598-024-80524-w • PMID: 39730519
Development of eSAH score (0–5) combining age, GCS, and SAHV. AUC: 0.89 (mRS), 0.75 (DCI), 0.88 (mortality). Derivation cohort n=277.
5. Bridging Continents, Closing Gaps: A Multicenter Cohort Study on Subarachnoid Hemorrhage Outcomes and Health Care Disparities
Neurocrit Care. 2026 (online ahead of print)
DOI: 10.1007/s12028-026-02460-z • PMID: 41776018
Multicenter cohort (n=1,145) from Brazil & USA. Documents disparities in SAH outcomes: higher mortality in Brazil (23.4% vs 13.4%), longer time to treatment (77.7 vs 4.3h). SAHV recognition could accelerate equitable care globally.
6. Computer-Assisted Volumetric Analysis Compared With ABC/2 Method for Assessing Warfarin-Related Intracranial Hemorrhage Volumes
Neurocrit Care. 2008;9(3):307–12
DOI: 10.1007/s12028-008-9089-4 • PMID: 18392784
Compared ABC/2 to computer-assisted volumetric analysis in warfarin-related ICH (n=8). ABC/2 accurately estimates smaller ellipsoid IPH and SDH without requiring an additional ÷2 correction. Larger, complex-shaped hematomas may be underestimated by ABC/2.
Article metadata retrieved from PubMed. IVH measured using the Modified Graeb Score per Morgan TC et al., Stroke 2013;44(3):635-41 (doi:10.1161/STROKEAHA.112.670653).
Enhanced SAH (eSAH) Score Calculator
Weighted score (0–5) combining Age, GCS, and SAHV. AUC = 0.89 (mRS), 0.88 (mortality). Sharma, Freeman et al., Sci Rep 2024.
0
Low risk — eSAH 0: favorable outcomes expected
Validated: AUC 0.78 (unfavorable outcome), 0.799 (mortality) across US & Brazil (de Oliveira Souza, Freeman et al., Sci Rep 2025). Each +1 point = OR 2.14 for poor outcome.
Intraventricular Hemorrhage — Modified Graeb Score
Morgan TC, Dawson J, Spengler D, et al. Stroke. 2013;44(3):635-41. doi:10.1161/STROKEAHA.112.670653
Score range: 0–32. Higher scores indicate greater IVH burden.
| Ventricle | Score (0–4) | Expansion (0/1) |
|---|---|---|
| Left Lateral (frontal horn) | ||
| Right Lateral (frontal horn) | ||
| Left Lateral (body) | ||
| Right Lateral (body) | ||
| Left Lateral (temporal horn) | ||
| Right Lateral (temporal horn) | ||
| Third Ventricle | ||
| Fourth Ventricle |
Modified Graeb Score
0 / 32
SAHVAI-MM (MultiModal) Calculator
Integrated outcome prediction combining eSAH, CHESS, NLR, and SAHV–DCI risk
e eSAH Score — Mortality & Poor Outcome Prediction
Weighted score (0–5) combining Age, GCS, and SAHV. AUC = 0.89 (mRS), 0.88 (mortality). Auto-fills from Calculator tab if populated, or enter directly below.
eSAH Score
0/5
—
Mortality Risk
—
Poor Outcome (mRS 4–6)
Enter Age, GCS, and SAHV to calculate eSAH
Scoring: Age >55 (+1 pt) | GCS 8–12 (+1 pt), 3–7 (+2 pts) | SAHV 10–20 mL (+1 pt), >20 mL (+2 pts)
5-Cistern SAHV
0.000 mL
Age / GCS
— / —
Mod. Graeb (IVH)
0 / 32
C CHESS Score — Shunt Dependency Risk
Hydrocephalus risk after SAH. Predicts need for ventriculoperitoneal shunt.
CHESS Score
0 / 8
Shunt dependency risk: Low
N Neutrophil-to-Lymphocyte Ratio (NLR)
Inflammatory biomarker predicting DCI. NLR >12.03 cutoff (AUC 0.805).
NLR
—
Enter neutrophil and lymphocyte counts
SAHV-Based DCI Risk
Calculated from Calculator tab SAHV
∑ MultiModal Clinical Summary
eSAH Mortality
—
CHESS Shunt Risk
—
NLR DCI Risk
—
Overall Risk
—
Monitoring Recommendation: Enter clinical data to generate multimodal risk profile.
Based on validated scores: eSAH (Sharma/Freeman, Sci Rep 2024), CHESS (Diesing et al.), NLR & SAHV-DCI (Föttinger/Freeman, JAHA 2024). For research and clinical decision-support only.