Articles: subarachnoid-hemorrhage.
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Zhonghua nei ke za zhi · Jun 1993
[Effect of elevated plasma norepinephrine on electrocardiographic changes in subarachnoid hemorrhage].
We compared electrocardiographic abnormalities and plasma norepinephrine concentration in 40 patients with subarachnoid hemorrhage within the first 24 hours, at 72 hours, and after 1 week. In the 20 patients with high plasma norepinephrine concentrations within the first 24 hours, sinus tachycardia and negative T waves were more frequently seen than in the 20 patients with normal plasma norepinephrine concentrations. ⋯ QT prolongation, U waves, ST depression, and arrhythmias were found with similar frequency in patients with high and normal plasma norepinephrine concentrations. We conclude that, with the exception of sinus tachycardia and negative T waves, other electrocardiographic changes in patients with subarachnoid hemorrhage do not depend on elevated plasma norepinephrine concentrations.
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Comparative Study
Amount of blood on computed tomography as an independent predictor after aneurysm rupture.
After admission to the hospital of patients with aneurysmal subarachnoid hemorrhage, we assessed the predictive value of the extent of the hemorrhage on computed tomography in addition to that of clinical grading scales for poor outcome, infarction, and rebleeding. ⋯ The total amount of subarachnoid blood on the initial computed tomogram has independent predictive power for the occurrence of delayed cerebral ischemia.
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Aneurysmal subarachnoid haemorrhage is a challenging pathology which remains a cause of considerable mortality and morbidity. To demonstrate to general practitioners the results of surgery for this condition a retrospective study of 160 consecutive cases who had undergone aneurysmal surgery was carried out. On admission 57% of cases had a good Hunt and Hess grade (grades I and II) and 43% a poor grade (grades III, IV and V). ⋯ Fifty-five per cent of cases made a good recovery (back to normality), 15% a fair recovery (moderately disabled but independent), 15% a poor recovery (severely disabled and dependent), and 15% died. The significant poor prognostic factors were: a poor pre-operative Hunt and Hess grade, the presence of an intracerebral haematoma or angiographic spasm, evidence of rebleeding and early surgery without treatment with nimodipine. Other factors which did not reach a statistical significance include: age, presence of subarachnoid and intraventricular blood on CT, timing of surgery, history of long-standing hypertension, intraoperative rupture, and the development of hydrocephalus or delayed ischaemia.
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The objective of this study was to assess the effect of referral bias on survival in patients with subarachnoid hemorrhage (SAH). The characteristics of 49 patients with aneurysmal SAH from a single community were compared with those of 328 patients referred from outside the community, all treated in the same medical care setting. In addition, referral patients who received surgery were compared by differential survival analysis with those still awaiting surgery at Days 1 to 3, Days 4 to 10, and Days 11 to 15. ⋯ Patients who underwent early surgical treatment had a 1-year survival rate almost identical to that of patients with late surgery. Referral patients had a better early survival rate than did community patients because the referral group did not include patients who died and some who were in poor clinical condition before the opportunity for referral. The differential survival analysis described provides a new method for estimating survival for treated and untreated patients with SAH.