Prognostic Factors of Subarachnoid Hemorrhage Due to Ruptured Cerebral Aneurysm: A Retrospective Analysis of 231 Patients
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The clinical outcome of aneurysmal subarachnoid hemorrhage (SAH) is influenced by many variables. The purpose of this study was to determine the prognostic factors of patients diagnosed as having cerebral aneurysmal SAH. Medical records of 231 patients (86 men and 145 women), diagnosed with aneurysmal SAH at some time during an 8-year period between January 1991 and December 1998, were investigated retrospectively. All patients were diagnosed with SAH by computed tomography (CT), and the presence of an aneurysm was diagnosed by conventional cerebral angiography. Sixteen of the 231 patients died prior to surgery. Surgical clipping or wrapping of the aneurysm was performed on 181 patients; 149 (82.3%) were 69 years of age or younger, and 32 (17.7%) were 70 years of age or older. In the total 231 patients, favorable outcome and mortality rate was 60.6% and 23.4%, respectively. In operated cases, favorable outcome and mortality rate was 70.2% and 15.5%, respectively. One hundred and sixty-six patients (91.7%) underwent early surgery (Day 0, 1, 2 or 3), and 15 (8.3%) underwent delayed surgery. During surgery, 86.5% patients classified as grade I-III showed favorable clinical outcomes, in contrast to 44.3% of patients classified as grade N and V. A total of 42.6% of patients over 70 years old had favorable outcomes. In conclusion, risk factors of aneurysmal SAH identified by this retrospective analysis were : Age 70 years or older, a poor grade according to Hunt and Hess upon admission, rebleeding of the aneurysm and symptomatic vasospasm.
- 昭和大学・昭和医学会の論文
昭和大学・昭和医学会 | 論文
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