A curated set of reference-sourced calculators and clinical tools for use with neurosurgery patients. Every calculation runs locally in your browser, no patient data is sent to any server.
The standard assessment of the level of consciousness. For patients aged ≥ 5 years. Use the paediatric version (PGCS) below for younger or pre-verbal children.
An adaptation of the GCS for children under about 5 years of age or who are pre-verbal. Only the Verbal component differs, the Eye and Motor components are the same as the standard GCS.
Predicts the probability of ETV success in paediatric hydrocephalus based on age, aetiology, and the presence of a prior shunt. The score runs from 0 to 90, it approximates the probability of ETV success at 6 months.
Grades cerebral AVMs from 1 to 5 based on three features (the size, the pattern of venous drainage, and the eloquence of the surrounding brain). Correlates with surgical risk. Grade 6 = inoperable.
The ratio of the maximum width of the frontal horns of the lateral ventricles to the maximum internal skull diameter on the same axial slice. Used to assess ventriculomegaly. Values > 0.30 are considered abnormal in adults, paediatric thresholds vary by age.
The hourly maintenance fluid rate based on weight, 4 mL/kg/hr for the first 10 kg, then 2 mL/kg/hr for the next 10 kg, then 1 mL/kg/hr for each kg above 20 kg.
Estimates the free water required to correct hypernatraemia. Useful in children with diabetes insipidus after neurosurgery in the pituitary region. The correction rate should not exceed 0.5 mEq/L/hour, to avoid cerebral oedema.
A functional outcome scale used after stroke or brain injury. Seven grades from 0 to 6. Widely used in neurosurgical trials and research.
Hematoma volume measurement (epidural, subdural, intracerebral) and prognostic scoring.
A rapid estimation of intracranial haematoma volume on CT. Applies to epidural (EDH), subdural (SDH), and intracerebral (ICH) haematomas. Volume = (A × B × C) ÷ 2, where A = largest diameter, B = diameter perpendicular to A, C = cranio-caudal extent, all measured in cm.
Clinical note — surgical evacuation thresholds: Per the Brain Trauma Foundation (BTF) surgical-management guidelines, an epidural haematoma (EDH) greater than 30 cm³ should be evacuated regardless of GCS, and an acute subdural haematoma (ASDH) should be evacuated if its thickness exceeds 10 mm or the midline shift exceeds 5 mm. These remain guideline thresholds, to be integrated with the full clinical picture and the patient's neurological status.
Predicts the 30-day mortality after spontaneous intracerebral haemorrhage in adults. Five components, score 0 to 6. Not formally validated in paediatrics.
A simple grading scale for spontaneous intracerebral haemorrhage in children. Four components, score 0 to 5. Predicts a poor functional outcome (mRS ≥ 3) at discharge.
Important caution. Drug doses carry a higher responsibility for error than any other section here. Always verify against your local protocol and pharmacy for each patient. Maximum doses, infusion limits, and contraindications are stated for each drug, they do not replace clinical judgment.
A potent long-acting corticosteroid. Reduces the oedema around brain tumors and tumor-like lesions. Not effective for trauma-related or ischaemic brain oedema.
An osmotic agent that draws water from the brain into the intravascular space. Used in acute raised ICP, impending herniation, and as part of neurosurgical preparation.
An alternative (or an adjunct) to mannitol for ICP control. Preferred in hypovolaemic or renally impaired patients. A central line is preferred, but a short peripheral bolus is acceptable in an emergency.
An anticonvulsant used for post-craniotomy seizure prophylaxis or for the control of acute seizures. Fosphenytoin is preferred when it is available, because of its better IV safety profile.
An alternative anticonvulsant to phenytoin, with a better safety profile, fewer drug interactions, and no need for routine level monitoring. It is increasingly preferred for post-operative prophylaxis and for status epilepticus.
The standard pre-operative prophylactic antibiotic for craniotomy, shunt insertion, and most clean neurosurgical operations. Administered within 60 minutes of the incision and re-dosed every 4 hours intraoperatively.
A reference table, the values can vary by laboratory method, verify against your local reference values.
| Age | WBC (/mm³) | Protein (mg/dL) | Glucose (mg/dL) | Opening pressure (cm H₂O) |
|---|---|---|---|---|
| Neonate | 0–30 | 20–170 | 30–120 | 8–11 |
| Infant (> 1 month) | 0–10 | 15–45 | 40–80 | 10–18 |
| Older child | 0–5 | 15–45 | 40–80 | 10–25 |
| Adolescent / adult | 0–5 | 15–45 | 50–80 | 10–25 |
For children from 1 to 16 years of age. Based on parent observation of the level of play and activity.
| % | Description |
|---|---|
| 100 | Fully active, normal |
| 90 | Minor restrictions in strenuous physical activity |
| 80 | Active but tires more quickly |
| 70 | Both greater restriction of and less time spent in active play |
| 60 | Up and around but minimal active play; keeps busy with quieter activities |
| 50 | Gets dressed but lies around most of the day; no active play |
| 40 | Mostly in bed; participates in quiet activities |
| 30 | In bed; needs assistance even for quiet play |
| 20 | Often sleeping; play entirely limited to very passive activities |
| 10 | No play; does not get out of bed |
| 0 | Unresponsive |
For adolescents and adults. Used in oncology trials, in the assessment of surgical eligibility, and in outcome follow-up.
| % | Description |
|---|---|
| 100 | Normal; no complaints; no evidence of disease |
| 90 | Able to carry on normal activity; minor symptoms |
| 80 | Normal activity with effort; some symptoms |
| 70 | Cares for self; unable to carry on normal activity or work |
| 60 | Requires occasional assistance; cares for most needs |
| 50 | Requires considerable assistance and frequent medical care |
| 40 | Disabled; requires special care and assistance |
| 30 | Severely disabled; hospitalization indicated |
| 20 | Very sick; active supportive treatment necessary |
| 10 | Moribund; fatal processes progressing rapidly |
| 0 | Dead |