Long-term results in patients with intracranial aneurismal subarachnoid hemorrhages and their prognosis.
DOI:
https://doi.org/10.26641/2307-0404.2015.2.45654Keywords:
intracranial aneurism hemorrhage, risk factors, therapeutic hypothermia, rules of prognosisAbstract
In 260 patients with intracranial aneurism hemorrhages long-term results were estimated according to Rankin scale 2,5 years after operation. Long-term results by Rankin 0-2 were considered to be “good”, 3-5 were considered to be “bad” ones. Two years after operation 53% of all patients had “good” long-term outcome. Factors negatively influencing long-term outcomes are to be the following: intra-operational aneurism rupture, temporary arterial clipping in the process of operation, complications in the post-operational period, angiospasm according to the transcranial Doppler sonography, angiospasm prevalence, clinicopathologic hemorrhage characteristics “subarachnoid hemorrhage+others”, critical condition according to H-H>1, feminine sex, aneurism location in the forebrain arteria, subarachnoid hemorrhage lesion according to Fisher> II, ischemic heart disease, pathological comorbitidy, ABO blood group – III or IV. “Good” treatment results 2,5 years after treatment are prognosticated in patients with severe invalidity by Glasgo scale (GOS=3) on hospital discharge, in those who didn’t experience ischemic stroke after operation and with severity of condition I or II according to H-H on admission. In patients with GOS-3 on hospital discharge the best long-term results according to Rankin were observed in those treated under hypothermia conditions. Hypertensive disease worsens long-term results according to Rankin even in patients with GOS-5 on hospital discharge. With positive renovation results by Rankin 0 or 1 in the post-operation period (GOS = 5) excellent long-term results are prognosticated, but the best results could be obtained in patients without hypertensive disease under prophylactic hypothermia.
References
Voroncov KV. [Combinatorics approach to the estimation of quality of the taught algorithms]. Mate¬maticheskie voprosy kibernetiki. 2004;13: 5–36. Russian 2. Zagorujko NG. [Applied methods of analysis of data and knowledge]. – Novosibirsk: Institut matematiki. 1999;266. Russian 3. Babak VP, Bіlec'kij AJ., Pristavka OP, Pristavka PO. [Statistical processing of data]. К.: MIVVZ. 2001;388. Russian 4. Shahidi A. [Derev'ja reshenij – C4.5 matema¬ticheskij aparat]. Available from: http://www.base¬group.ru/library/analysis/tree/math_c45_part1 5. Lanzino G, Kassell NF, Germanson TP, Kon¬gable GL, Truskowski LL, Torner JC, Jane JA. Age and outcome after aneurysmal subarachnoid hemorrhage: why do older patients fare worse? Journal of Neurosurgery. 1996;85:410-8. 6. Chahal N, Barker-Collo S, Feigin V. Cognitive and functional outcomes of 5-year subarachnoid haemor¬rhage survivors: comparison to matched healthy controls. Neuroepidemiology. 2011;37:31-38. 7. Timour Al-Khindi, R Loch Macdonald, MD, PhD, Tom A. Schweizer Cognitive and Functional Out¬come After Aneurysmal Subarachnoid Hemorrhage. Stro¬ke. 2010;41:5619-536. 8. Visser-Meily JM, Rhebergen ML, Rinkel GJ, van Zandvoort MJ, Post MW. Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics. Stroke. 2009;40:1526-9. 9. Ogden JA, Mee EW, Henning M. A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage. Neurosurgery. 1993;33:572-86. 10. Springer MV, Schmidt JM, Wartenberg KE, Frontera JA, Badjatia N, Mayer SA. Predictors of global cognitive impairment 1 year after subarachnoid hemor¬rhage. Neurosurgery. 2009;65:1043-50. 11. Robert M Starke, Ricardo J Komotar, Marc L Ot¬ten, J Michael Schmidt, Luis D Fernandez, Fred Rincon, Errol Gordon, Neeraj Badjatia, Stephan A Mayer, E Sander Connolly. Predicting long-term outcome in poor grade aneurysmal subarachnoid haemorrhage patients utilising the Glasgow Coma Scale. Journal of Clinical Neuroscience. 2009;16:26–31. 12. Mocco J, Ransom ER, Komotar RJ, Schmidt JM, Sciacca RR, Mayer SA, Connolly ES. Preoperative pre-dic¬tion of long-term outcome in poor-grade aneurysmal su¬barachnoid hemorrhage. Neurosurgery. 2006;59:529-38. 13. Rosengart AJ, Schultheiss KE, Tolentino J, Mac¬donald RL. Prognostic factors for outcome in patients with aneurysmal subarachnoid hemorrhage. Stroke. 2007;8:2315-21. 14. Rinkel GJ, Algra A. Long-term outcomes of pa¬tients with aneurysmal subarachnoid haemorrhage. Lancet Neurology. 2011;10:349-56. 15. Jeannette W. Hop, Gabriel JE Rinkel, Ale Algra and Jan van Gijn. Quality of Life in Patients and Partners After Aneurysmal Subarachnoid Hemorrhage. Stroke. 1998;29:798-804. 16. Wilson JT, Pettigrew LE, Teasdale GM. Struc¬tured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use. J. Neurotrauma.1998;15:573–85.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Medical Perspectives
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.
