| Is this Subarachnoid Hemorrhage Significant? A National Survey of Neurosurgeons. | |
| | |
MedLine Citation:
|
PMID: 22931706 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
Background: Previously all subarachnoid hemorrhage (SAH) patients were admitted, whereas now patients with angiography may be discharged. Objective: To survey neurosurgeons to determine current practice and what constitutes a clinically significant subarachnoid hemorrhage. Methods: We surveyed all neurosurgeons listed in the Canadian Medical Directory. We used a modified Dillman technique with up to five mailed surveys plus a pre-notification letter. Neurosurgeons rated the significance of 13 scenarios of subarachnoid hemorrhage. Scenarios varied from aneurysmal subarachnoid hemorrhage to patients with isolated xanthochromia in cerebrospinal fluid. Each scenario was rated for clinical significance using a 5-point scale [1(always) to 5(never)]. Results: Of the 224 surveyed, 115 neurosurgeons responded. Scenarios with aneurysms requiring intervention, arteriovenous malformations, death or any surgical intervention all had median responses of 1 (IQR 1, 1). Scenarios having xanthochromia and few red blood cells in cerebrospinal fluid with negative computerized tomogram (CT) and angiography had median responses of 3 (IQR 1, 4). Scenarios with perimesencephalic pattern on CT with negative angiography had median of 3 (IQR 2, 4). Scenarios where patient is discharged from the emergency department had median of 4 (IQR 3, 5). Conclusion: Subarachnoid hemorrhages due to aneurysms or arteriovenous malformations causing death or requiring surgical intervention are always clinically significant. Other types of nonaneurysmal subarachnoid hemorrhages had inconsistent ratings for clinical significance. These survey results highlight the need for further discussions to standardize the diagnosis of what constitutes a clinically significant subarachnoid hemorrhage and what care should be afforded to these patients. |
| | |
Authors:
|
Jeffrey J Perry; Cheryl Symington; Marlène Mansour; Monica Taljaard; Ian G Stiell |
Related Documents
:
|
10378236 - Combined electroconvulsive therapy and clozapine in treatment-resistant schizophrenia. 21502706 - Plaque-stabilizing effect of atorvastatin is stronger for plaques evaluated as more uns... 21406436 - Effect of the combination of clarithromycin and amikacin on pseudomonas aeruginosa biof... 21452246 - Third in-stent restenosis in sirolimus eluting stents: predictors of the next restenosis. 21575026 - Comparison of primary octreotide-lar and surgical treatment in newly diagnosed patients... 20025646 - Pulmonary embolism severity index and troponin testing for the selection of low-risk pa... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques Volume: 39 ISSN: 0317-1671 ISO Abbreviation: Can J Neurol Sci Publication Date: 2012 Sep |
Date Detail:
|
Created Date: 2012-08-30 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0415227 Medline TA: Can J Neurol Sci Country: Canada |
Other Details:
|
Languages: eng Pagination: 638-43 Citation Subset: IM |
Affiliation:
|
Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Does extent of resection impact survival in patients bearing glioblastoma?
Next Document: Delays in initiation of acyclovir therapy in herpes simplex encephalitis.