Time course of neurological grading in patients with severe SAH and prognosis

Short-term observation of patients with subarachnoid hemorrhage(SAH) but without hematoma presenting in poor neurological condition on admission was evaluated as a protocol to select candidates for radical surgery. One hundred three patients with SAH but without hematoma causing mass effect were observed for 12 hours with control of blood pressure and intracranial pressure(ICP) using hyperosmolar diuretics and/or ventricular drainage. Neurological improvement was seen in 32 of 47 patients in grade IV on admission and 23 of 56 patients in grade V(p<0.01). Hydrocephalus requiring ventricular drainage was more common(p<0.05), and the interval between admission and onset was shorter(p<0.01)in the improved group. Rebleeding during observation occurred in 3 patients in grade V on admission. Radical surgery was performed on all patients in grade III or better after 12-hour observation, and patients in grade IV below 75 years old and without systemic complication

くも膜下出血

神経学的グレード

経過

手術適応

予後

本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである