| Classification of non-aneurysmal subarachnoid haemorrhage: CT correlation to the clinical outcome. | |
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MedLine Citation:
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PMID: 20599064 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To propose a new computed tomography (CT)-based classification system for non-aneurysmal subarachnoid haemorrhage (SAH), which predicts patients' discharge clinical outcome and helps to prioritize appropriate patient management. METHODS AND MATERIALS: A 5-year, retrospective, two-centre study was carried out involving 1486 patients presenting with SAH. One hundred and ninety patients with non-aneurysmal SAH were included in the study. Initial cranial CT findings at admission were correlated with the patients' discharge outcomes measured using the Modified Rankin Scale (MRS). A CT-based classification system (type 1-4) was devised based on the topography of the initial haemorrhage pattern. RESULTS: Seventy-five percent of the patients had type 1 haemorrhage and all these patients had a good clinical outcome with a discharge MRS of <or=1. Eight percent of the patients presented with type 2 haemorrhage, 62% of which were discharged with MRS of <or=1 and 12% of patients had MRS 3 or 4. Type 3 haemorrhage was found in 10%, of which 16% had good clinical outcome, but 53% had moderate to severe disability (MRS 3 and 4) and 5% were discharged with severe disability (MRS 5). Six percent of patients presented with type 4 haemorrhage of which 42% of the patients had moderate to severe disability (MRS 3 and 4), 42% had severe disability and one-sixth of the patients died. Highly significant differences were found between type 1(1a and 1b) and type 2 (p=0.003); type 2 and type 3 (p=0.002); type 3 and type 4 (p=0.001). CONCLUSION: Haemorrhages of the type 1 category are usually benign and do not warrant an extensive battery of clinical and radiological investigations. Type 2 haemorrhages have a varying prognosis and need to be investigated and managed along similar lines as that of an aneurysmal haemorrhage with emphasis towards radiological investigation. Type 3 and type 4 haemorrhages need to be extensively investigated to find an underlying cause. |
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Authors:
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S Nayak; A B Kunz; K Kieslinger; G Ladurner; M Killer |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2010-06-17 |
Journal Detail:
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Title: Clinical radiology Volume: 65 ISSN: 1365-229X ISO Abbreviation: Clin Radiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-11-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306016 Medline TA: Clin Radiol Country: England |
Other Details:
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Languages: eng Pagination: 623-8 Citation Subset: IM |
Affiliation:
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Department of Neuroradiology, University Hospital of North Staffordshire, North Staffordshire Royal Infirmary, Stoke-on-Trent, Staffordshire, UK. sanjeevnayak@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Austria / epidemiology Cerebral Angiography / methods Female Great Britain / epidemiology Humans Male Middle Aged Patient Discharge / statistics & numerical data* Prognosis Retrospective Studies Subarachnoid Hemorrhage / classification, epidemiology, radiography* Tomography, X-Ray Computed Treatment Outcome Young Adult |
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