Document Detail


Classification of non-aneurysmal subarachnoid haemorrhage: CT correlation to the clinical outcome.
MedLine Citation:
PMID:  20599064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S Nayak; A B Kunz; K Kieslinger; G Ladurner; M Killer
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-06-17
Journal Detail:
Title:  Clinical radiology     Volume:  65     ISSN:  1365-229X     ISO Abbreviation:  Clin Radiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  623-8     Citation Subset:  IM    
Affiliation:
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:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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