Tratamiento de la hemorragia subaracnoidea aneurismática en el Hospital Clínico de la Universidad de Chile / Subarachnoid hemorrhage caused by intracranial aneurysms, experience in 82 patients

Background: One third of patients with subarachnoid hemorrhage caused by intracranial aneurysms, die. Aim: Review of medical records of patients with subarachnoid hemorrhage treated at a clinical hospital. Material and Methods: Review of medical records of patients discharged from the hospital between 2006 and 2011 with the diagnosis of subarachnoid hemorrhage. Patients initially or subsequently treated elsewhere were not analyzed. Results: The medical records of 82 patients aged 24 to 100 years (77% females), were analyzed. The clinical diagnosis at the onset of the condition was correct in 82% of cases. In 95% of patients, an angiographic study and subsequent surgical intervention of the aneurysm were carried out within 24 hours of diagnosis. Global mortality was 23%. Twelve patients died prior to any possible treatment, due to the severity of the disease. Seventy six aneurysms in 70 patients were treated with clips or coils in 37 and 39 cases, respectively. Seven patients died. Forty seven patients had a Rankin disability score of two or less. Conclusions: The presence of an intracranial hematoma or acute hydrocephaly on admission and clinical vasospasm during evolution were associated with a bad prognosis.

Efectos tardíos del traumatismo encefalocraneano / Late effects of head trauma

The recuperation after a head trauma is divided in three phases. Awakening from coma is the initial phase that normally occurs at the intensive care unit. The period of hospitalization when the threatens of death and neurological instability disappear is the intermediate phase. The post concussional syndrome occurs in the late phase, when the patients have been discharged from the hospital. This syndrome, despite the abscence of abnormalities in the clinical examination, causes an assortment of ailments that preclude normal activities. Organic neurological sequelae such as hemiplejia, speech disorders, cranial nerve lesions and mental disorders take also place in this phase. An adequate rehabilitation plan for the patient and his family must take into account all these issues