CT findings in acute stage of subarachnoid hemorrhage as regards the prognostic analysis
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概要
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Analysis of CT scan findings of the subarachnoid hemorrhage in acute stage was made as regards the severity of clinical symptoms and outcome of the patients. CT scan, which was taken within 4 days after the onset of subarachnoid hemorrhage, was available in 73 patients, most of them received examination shortly after the hemorrhagic attack, and the patients were classified in 3 groups according to their clinical course. The patients in group I were evaluated in grade I II of Hunt & Kosnik s classification and remained in uneventful clinical course. The cases in group II developed deteriorating symptoms such as progressive impairment of consciousness or motor difficulty, and/or had angiographic evidence of vasospasm. The group III patients were all expired in early stage of subarachnoid hemorrhage.<BR>The results obtained were as follows;<BR>1) The findings of CT scan in acute stage of subarachnoid hemorrhage were characterized by high density in subarachnoid spaces and various parts of the CSF cistern, especially in the bilateral sylvian fissure and the interhemispheric fissure. Those cisterns and fissures were also not infrequently unvisualized as diffuse iso-density zone.<BR>2) In group I, the CT scan showed that the cisterns and fissures were not totally involved and good numbers of cistern were spared from the CT evidence of subarachnoid hemorrhage. Often, the basal, ambient and quadrigeminal cisterns remained as low density zone. On the contrary, the CT scan of the group II showed more extensive high density filling in each cistern and most of the fissures disappeared.<BR>These CT findings were more conspicuous in group III and almost all of the cisterns and fissures were filled with high density material or they were totally unvisualized.<BR>3) Beside the findings above, CT scan of group III showed frequent association of intracerebral hematoma or intraventricular rupture of the hemorrhage.<BR>Except for several patients, group I and II patients received surgical treatment in convalescence and only one patient died after operation, who was in group II. About one third of patients in group II expired before the surgical treatment could be indicated. There was no death in group I.<BR>As the conclusion, the CT findings of subarachnoid hemorrhage in acute stage were of great value in estimating clinical course of each patient.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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