The Prevalence of Cerebrovascular Abnormalities Detected in Various Diagnostic Subgroups of Spontaneous Subarachnoid Hemorrhage in the Modern Era
| Autor: | Sean Martin, Mario Teo, E.J. St George, Isaac Phang, Ming Y. Chong, Nigel Suttner |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Intracranial Arteriovenous Malformations Male medicine.medical_specialty Subarachnoid hemorrhage Computed tomography 03 medical and health sciences 0302 clinical medicine Patient age medicine Prevalence Humans cardiovascular diseases 030212 general & internal medicine Prospective Studies Aged medicine.diagnostic_test Lumbar puncture business.industry Spontaneous subarachnoid hemorrhage Digital subtraction angiography Middle Aged Subarachnoid Hemorrhage medicine.disease nervous system diseases Patient management Angiography Surgery Female Neurology (clinical) Radiology business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 111 |
| ISSN: | 1878-8769 |
| Popis: | Objective To determine prevalence of cerebrovascular abnormalities in diagnostic subgroups of spontaneous subarachnoid hemorrhage (SAH) in a regional neurosurgical center in the modern era. Methods Data of 609 consecutive patients with spontaneous SAH in a 3-year period (August 2010 to August 2013) were prospectively collected. Patients were divided into 3 diagnostic subgroups: computed tomography (CT) positive for SAH; CT negative but positive cerebrospinal fluid examination by spectrophotometry for SAH; CT negative for SAH and inconclusive cerebrospinal fluid examination. All patients fit for intervention underwent CT angiography with or without digital subtraction angiography to identify vascular abnormalities for subsequent treatment. Results Of 609 patients, 554 were fit for further investigation and consideration of further intervention; 514 patients had confirmed SAH. Mean patient age was 54.0 years; 61.5% of patients were women. Of patients, 390 (75.9%) showed vascular abnormalities on angiography. There were 438 patients (85.2%) with confirmed SAH diagnosed on CT scan (group 1). Vascular abnormalities were detected in 81.1% of patients; 18.9% of patients with positive CT scan had no identifiable cause of SAH. Of patients with confirmed SAH, 76 (14.8%) had negative CT scan but positive lumbar puncture (group 2); 46.1% of patients in this group had vascular abnormalities. Three patients with inconclusive cerebrospinal fluid examination had lesions requiring treatment. Median length of hospital stay in group 1 patients was longer than median length of hospital stay in group 2 patients. Conclusions Frequency of vascular abnormalities in spontaneous SAH is lower than the traditionally quoted figure, which has diagnostic and prognostic implications for patient management. |
| Databáze: | OpenAIRE |
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