Comparing Outcomes of Patients With Idiopathic Subarachnoid Hemorrhage by Stratifying Perimesencephalic Bleeding Patterns.
J Stroke Cerebrovasc Dis
; 28(9): 2407-2413, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-31303438
ABSTRACT
BACKGROUND:
To determine the clinical outcomes of perimesencephalic subarachnoid hemorrhages based on the computed tomography (CT) bleeding patterns.METHODS:
This retrospective cohort study included (1) patients (≥18 years) admitted to a comprehensive stroke center (January 2015-May 2018), (2) with angiography-negative, nontraumatic subarachnoid hemorrhage in a perimesencephalic or diffuse bleeding pattern, and (3) had CT imaging performed in ≤ 72 hours of symptom onset. Patients were stratified by location of bleeding on CT Peri-1 focal prepontine hemorrhage; Peri-2 prepontine with suprasellar cistern +/- intraventricular extension; and diffuse.RESULTS:
Of the 39 patients included, 13 were Peri-1, 11 were Peri-2, and 15 were diffuse. The majority were male (nâ¯=â¯26), with a mean (standard deviation) age of 55.3 (11.3) years, who often presented with headache (nâ¯=â¯37) and nausea (nâ¯=â¯28). Overall, patients in Peri-1 were significantly less likely to have hydrocephalus compared to Peri-2 and dSAH (P= .003), and 4 patients required an external ventricular drain. Five patients developed symptomatic vasospasm. Patients in Peri-1, compared to Peri-2 and diffuse, had a significantly shorter median neuro critical care unit length of stay (LOS) and hospital LOS. Most patients (nâ¯=â¯35) had a discharge modified Rankin Score between 0 and 2 with no significant differences found between groups.CONCLUSION:
These data suggest that patients with the best clinical course were those in Peri-1, followed by Peri-2, and then diffuse. Because these patients often present with similar clinical signs, stratifying by hemorrhage pattern may help clinicians predict which patients with perimesencephalic subarachnoid hemorrhage develop complications.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Hemorragia Subaracnóidea
/
Tomografia Computadorizada por Raios X
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article