Barbiturate Coma Therapy in Severe and Refractory Vasospasm Following Subarachnoid Hemorrhage
Journal of Korean Neurosurgical Society
;
: 142-148, 2003.
Article
in Korean
| WPRIM
| ID: wpr-207740
ABSTRACT
OBJECTIVE:
This study is designed to evaluate the therapeutic effects and prognostic factors for barbituate coma therapy(BCT)in severe and refractory vasospasm following subarachnoid hemorrhage.METHODS:
Barbiturate coma therapy was used in 18 patients with severe and refractory vasospasm in spite of "3-H therapy" and intra-arterial papaverine infusion. The authors analyzed the clinical parameters including Glasgow Coma Scale(GCS), electroenceplographic finding, and brain computerized tomography(CT) scan findings in relation to outcome at discharge.RESULTS:
Among 18 patients, burst suppression pattern could be obtained in 17. In cases with good outcome, the duration elapsed from coma to drowsiness after BCT was 14.09+/-5.82 days and GCS score at this time was significant in the prediction of final outcome(p<0.05). Patients with ideal burst suppression pattern attainable more than 24 to 48 hours showed good outcome in 81.8%(p<0.05). The group that showed focal low density in the brain CT scan taken before BCT fared better prognosis compared with that of multifocal or diffuse low density(p<0.05), and patients with resolution of perimesencephalic cistern effacement on follow-up brain CT scan taken 48 hours after BCT showed better prognosis(p<0.05). Overall, 72.2% showed improvement of GCS score by 2 or more, and good outcome was noted in 50%.CONCLUSION:
The barbiturate coma therapy seems to have a beneficial therapeutic effect on severe and refractory vasospasm and can be considered as a useful therapeutic modality.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Papaverine
/
Prognosis
/
Sleep Stages
/
Subarachnoid Hemorrhage
/
Brain
/
Tomography, X-Ray Computed
/
Follow-Up Studies
/
Coma
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of Korean Neurosurgical Society
Year:
2003
Type:
Article
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