Spontaneous subarachnoid haemorrhage in the era of transition from surgery to embolization. A study of the overall outcome

Επιστημονική δημοσίευση - Άρθρο Περιοδικού uoadl:3097398 5 Αναγνώσεις

Μονάδα:
Ερευνητικό υλικό ΕΚΠΑ
Τίτλος:
Spontaneous subarachnoid haemorrhage in the era of transition from
surgery to embolization. A study of the overall outcome
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The aim of the investigation was to evaluate the outcome of sponteneous
subarachnoid haemorrhage, in the era of new techniques, patient
centralization and subspecialization, by taking into account the local
conditions in Greece. A prospective observational study was conducted
during a 4-year period. All patients with a first-ever spontaneous
subarachnoid haemorrhage were enrolled. Clinical, management and outcome
data were recorded. Two-hundred-and-eighteen consecutive patients with
an 81% good, medium clinical grade (Hunt & Hess I-III) were
identified. Rebleed and rebleed leading to death rates were 22 and 11
%, respectively. Permanent defict or death from vasospasm was 15 %.
Twenry-eight per cent of the study population died early, were
unsuitable for further management (poor clinical status, advanced age)
or declined angiography or treatment, and another 22% had a negative
angiogram. The remaining 50% underwent intervention
(neurosurgical/endovascular), for obliteration of an aneurysm. The
overall favourable 6-month outcome was 59%, whereas the favourable
outcome of the intervention group was 70%. Our results confirm the
findings of previous series. The relatively worse results are due to
delayed referral, and lack of availability of surgical or endovascular
management in the early post-haemorrhage period (28% of the patients),
particularly in potentially salvageable cases. On the basis of these
observations, we recommend early intervention (surgery or embolization)
and centralization/subspecialization, in order to improve the outcome.
Έτος δημοσίευσης:
2005
Συγγραφείς:
Stranjalis, G
Korfias, S
Vemmos, KN
Sakas, DE
Περιοδικό:
British Journal of Neurosurgery
Εκδότης:
TAYLOR & FRANCIS LTD LONDON
Τόμος:
19
Αριθμός / τεύχος:
5
Σελίδες:
389-394
Λέξεις-κλειδιά:
cerebral aneurysm; Greece; outcome; SAH; subarachnoid haemorrhage
Επίσημο URL (Εκδότης):
DOI:
10.1080/02688690500389781
Το ψηφιακό υλικό του τεκμηρίου δεν είναι διαθέσιμο.