Non-traumatic subarachnoid haemorhage: clinical onset symptoms as predictors for patients` clinical outcome
Keywords:subarachnoid haemorhage, saccular aneurysm, computer tomography/angiography, Glasgow Outcome Scale
Aim. In this article, we tried to find out whether any of SAH clinical symptoms can be both short-term and long-term predictors for patients.
Materials. 144 SAH / unruptured aneurysm patients, treated at Uzhgorod Regional Center of neurology and neurosurgery during 4 years, were examined. The patients were examined on standardized scales (WFNS, Hunt-Hess, GCS), neurovisual and other clinical criteria. The early clinical outcome was determined by GlasgowOutcomeScale.
Results and discussion. Considering the given clinical data, we can identify several predictors of a positive early outcome after aneurismal subarachnoid hemorrhage (i.e. 4 – 5 Glasgow Outcome Scale points):
- High level of consciousness, according to the GSC scale, at the moment of hospitalization;
- Hunt-Hess / WFNS I-II.
At the same time, low indicators of these scales in the disease onset are associated with a worse early outcome (1 – 3 Glasgow Outcome Scale points).
The young age is SAH risk factor, but it’s not the unambiguous feature for the disease prediction.
Also, a hypertension in anamnesis is one of the worse prediction indexes.
Conclusion. A correlation between epileptic seizures in SAH onset and higher risk of rebleeding was found out. Therefore, this clinical symptom can be a negative outcome predictor and requires more thorough attention and study.
We believe that even patients with good neurological recovery and the relative / complete independence after SAH in future can suffer from anxiety, depression, post-traumatic stress disorder and cognitive impairment, affecting quality of their lives. It should be considered in the long term – with cognitive function study and the use of quality of life scale in routine practice after SAH
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Copyright (c) 2017 Євгенія Іванівна Цьома, Володимир Іванович Смоланка, Юрій Юрійович Чомоляк, Тарас Олександрович Студеняк
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