TENC Neurocirurgia Practice Questions - TENC - Título De Especialista Em Neurocirurgia (Sociedade Brasileira De Neurocirurgia AMB) Exam

A 54-year-old woman presents to the emergency department with the sudden onset of the worst headache of her life ('thunderclap headache'), neck stiffness, and persistent vomiting. On physical examination, she is drowsy and confused but opens her eyes to voice, follows commands, and has no focal cranial nerve or motor deficits (Glasgow Coma Scale score 14). A non-contrast head CT demonstrates thick diffuse subarachnoid blood in the basal cisterns and interhemispheric fissure measuring greater than 1 mm in thickness, along with intraventricular hemorrhage in both lateral ventricles. Digital subtraction angiography confirms a ruptured 7 mm anterior communicating artery (ACom) aneurysm. According to the Hunt & Hess and modified Fisher grading systems, how is this patient's subarachnoid hemorrhage classified?