HeyHippocratesAneurysm, SAH, subdural, tumor — a colleague who cites every call.
Clinical decision support that reasons like a neurosurgeon while you decide: grade the bleed, weigh the aneurysm, cite the evidence — with the decision rule and exactly what would change it. Built for verified neurosurgeons.
Watch it think — in neurosurgery.
Two worked examples, reasoned the way it answers: the relevant clinical checks run, the answer is cited, the decision rule is explicit, and what is missing is flagged.
Ruptured aneurysm, GCS 13, mild confusion, no focal deficit — Hunt-Hess grade and next step?
That maps to Hunt-Hess grade II–III. Secure the ruptured aneurysm early (clip or coil) — early treatment cuts rebleed risk; start nimodipine for all aneurysmal SAH, treat hydrocephalus (consider EVD), and monitor for delayed cerebral ischemia / vasospasm on days 4–14.
Decision ruleGrades I–III → early aneurysm securing; nimodipine for every aSAH; watch vasospasm 4–14 days; EVD for symptomatic hydrocephalus.
Not established from this alone — exact GCS/exam, aneurysm morphology, and hydrocephalus on CT change the plan.
78-year-old on apixaban, 14 mm chronic subdural, mild confusion — operate or manage conservatively?
Symptomatic cSDH with significant thickness or midline shift is typically drained (burr-hole with a subdural drain lowers recurrence); hold and reverse anticoagulation first. Small, minimally symptomatic collections can be observed, and middle-meningeal-artery embolization is an emerging adjunct.
Decision ruleSymptoms + radiographic burden drive surgery; place a post-op subdural drain to cut recurrence; correct coagulopathy before operating.
Not established from this alone — GCS, midline shift, membrane/septation and reversal status change the plan.
Illustrative simulations. The physician always decides.
The answers neurosurgeons actually look up.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Hunt–Hess scale — how do I grade this SAH?
Hunt-Hess grades aneurysmal SAH by clinical status: I asymptomatic/mild headache; II moderate–severe headache or cranial-nerve palsy, no other deficit; III drowsiness, confusion or mild focal deficit; IV stupor, moderate–severe hemiparesis; V coma/decerebrate. Lower grade predicts better outcome and favors early securing.Hunt & Hess
Decision ruleGrade I–III → early aneurysm treatment; grade IV–V → resuscitate/stabilize (EVD for hydrocephalus) then reassess; grade guides prognosis and timing.
Missing data: GCS, focal deficit, ventricular size and rebleed all refine grade and timing.
Subarachnoid hemorrhage — the first-hour priorities?
Confirm with non-contrast CT (LP if negative and suspicion high), then CTA/DSA to find the source. Secure the aneurysm early by clipping or coiling, control blood pressure until secured, start nimodipine, and treat acute hydrocephalus with an EVD. Reverse any coagulopathy.guideline synthesis
Decision ruleDiagnose → localize → secure early → nimodipine → manage ICP/hydrocephalus → watch vasospasm days 4–14.
Missing data: aneurysm location/morphology, hydrocephalus and clinical grade drive the securing strategy.
Chronic subdural hematoma — operate or observe?
Symptomatic cSDH with significant thickness or midline shift is typically drained — burr-hole with a subdural drain reduces recurrence. Small, minimally symptomatic collections can be observed; MMA embolization is an emerging adjunct, especially for recurrence or poor surgical candidates.guideline synthesis
Decision ruleSymptoms + radiographic burden drive surgery; subdural drain post-op; reserve observation for thin, asymptomatic collections.
Missing data: GCS, anticoagulation/reversal, membranes and functional baseline change the plan.
Unruptured aneurysm — treat or observe (PHASES)?
For most incidental aneurysms <7 mm in the anterior circulation without prior SAH, observation with interval imaging is reasonable. Size, posterior-circulation location, documented growth, family history and younger age shift the balance toward securing it.PHASES · UIATS
Decision ruleWeigh rupture risk (PHASES) against procedural risk; posterior circulation, prior SAH, growth or younger age push toward treatment.
Missing data: exact size and morphology, location, family history and smoking status change the recommendation.
What it knows in neurosurgery
Your whole practice, one specialist brain — grounded in specialist-written, cited knowledge.
A generalist neurosurgery colleague across vascular, trauma, tumor, spine and functional — cited, non-directive, always with the decision rule.
Deep specialist agents for vascular & skull-base, functional & epilepsy and brain-tumor — each its own specialist voice and knowledge base — plus your own uploaded materials.
Why not just use OpenEvidence or ChatGPT?
A large language model answers any clinical question with total confidence and no idea whether it is right. A search engine finds papers. HeyHippocrates reasons inside your specialty from a knowledge base a specialist in your field wrote and signed, and tells you the decision rule and what is missing.
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Questions neurosurgeons ask
It works in the scales you use — Hunt-Hess and WFNS for aSAH, plus modified Fisher for vasospasm risk — and always shows the reasoning behind the grade and what would change it. The grade always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion between cases. Access is gated to verified physicians.
Vascular & skull-base, functional & epilepsy, and brain-tumor each have their own deep specialist agent on the Pro plan, on top of the full main neurosurgical scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in specialist-written, cited neurosurgical knowledge — traceable to a named source — and always states the decision rule plus what data is missing, instead of a confident guess.