Articles: subarachnoid-hemorrhage.
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To determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in whom the diagnosis was delayed. ⋯ Earlier diagnosis, allowing early definitive surgical treatment, may improve the outcome in aneurysmal subarachnoid haemorrhage. The results of a computed tomography scan are diagnostic only if they are positive--a negative result must be interpreted in conjunction with the clinical picture.
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Comparative Study
A two-year survey of aneurysmal subarachnoid haemorrhage.
To analyse the demographic characteristics and outcomes of patients with rupture of an intracranial aneurysm--to make a comparison with other published results, and to determine whether improvements in management can be made. ⋯ A speedier referral of these patients to a neurosurgical unit may lead to an improvement in outcome.
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Fifty-two cases of acute phase subarachnoid hemorrhage were studied by brain CT scanning to determine the presence and incidence of ischemic myocardial disorder, the relationship between ischemic change and severity, disease prognosis, and the relationship between acute phase circulatory dynamics and so-called neurogenic pulmonary edema. In all cases, ECGs were carried out and CPK-MB determined. Some of the patients underwent Tl myocardial scintigraphy, echocardiography, cardiac catheterization, as well as circulatory dynamic investigation (by Swan-Ganz catheter) and arterial blood gas analysis. ⋯ This could account for onset of symptoms. These findings support the need for adequate circulatory management in cases of acute subarachnoid hemorrhage with pulmonary edema and/or changes on ECG. In such cases, concurrent catheterization and cerebral angiography (cerebro-cardiac catheterization: CCC) proved effective for evaluating cardiac function and determining whether heart disease was also present.
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Acta Neurol. Scand. · Apr 1991
Cerebral blood flow and metabolism following subarachnoid haemorrhage: effect of subarachnoid blood.
The amount of effused blood following a subarachnoid haemorrhage (SAH) was estimated in 48 patients by cerebral computerized tomographic scanning. The cerebral oxygen consumption (CMRO2) was calculated as arteriovenous difference for oxygen multiplied by mean cerebral blood flow measured by the 133-Xe inhalation technique. A significant negative correlation was observed between CMRO2 and amount of subarachnoid blood, with additional reduction in CMRO2 in case of ventricular bleeding. ⋯ A correlation was observed for blood flow measured at day 5 and further on, indicating a restored coupling between flow and metabolism. The clinical (Hunt) grade on admission and the outcome correlated to the amount of blood. These observations suggest that the acute reduction in CMRO2 following a SAH is mainly determined by the amount of blood escaping during the aneurysm rupture, and that the cerebral blood flow level a few days after SAH mainly is determined by the initial reduction in oxygen uptake.
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Journal of neurosurgery · Mar 1991
Case ReportsSubarachnoid hemorrhage from a dissecting aneurysm of the middle cerebral artery. Case report.
A case of subarachnoid hemorrhage (SAH) from a dissecting aneurysm of the inferior limb of the middle cerebral artery is reported. The patient's clinical status and the initial and follow-up angiographic appearance of the aneurysm are presented. Diagnosis and treatment are briefly discussed. It is suggested that, if angiography demonstrates luminal narrowing or vascular occlusion in a patient with unexplained SAH, a dissecting aneurysm of the carotid system should be considered as a cause of the hemorrhage.