Optimal Treatment in Patients with Ruptured Middle Cerebral Artery Aneurysms and Intracranial Hematoma According to Hematoma Distribution / 대한뇌혈관외과학회지
Korean Journal of Cerebrovascular Surgery
; : 141-146, 2010.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-124992
Biblioteca responsable:
WPRO
ABSTRACT
OBJECTIVE:
This study aimed to determine the clinical courses and optimal treatments for patients suffering from ruptured middle cerebral artery (MCA) aneurysms with either intracerebral (ICHs) or sylvian hematomas (SylH), based on hematoma distribution.METHODS:
We grouped 49 patients with Fisher grade III or IV subarachnoid hemorrhages, who underwent aneurysmal neck clipping and hematoma evacuation within 24 hours of developing an intracranial hematoma, according to hematoma distribution. Group A comprised 21 patients who had ICHs<30 ml, while group B comprised 28 patients with dense SylHs<30 ml.Result:
Immediate postoperative brain computerized tomography findings showed residual hematomas in 3 group A patients (14.3%) and 20 group B patients (71.7%). We noted post-operative brain edema in 5 group A (23.8%) and 15 group B patients (53.6%). Vasospasm developed in 4 group A (19.0%) and 20 group B patients (71.4%; p<0.05). In group A, 12 patients (57.1%) had focal neurologic deficits upon discharge, while 5 patients died. In group B, 9 patients (32.1%) had focal neurologic deficits upon discharge, while 8 died (p<0.05). Normal pressure hydrocephalus developed in 1 patient (4.8%) in group A and 5 in group B (17.9%). Favorable outcomes were achieved in 9 patients (42.9%) in group A and 4 (14.3%) in group B.CONCLUSION:
Patients who experienced ruptured MCA aneurysms with SylHs had more severe clinical courses and poorer outcomes than patients with ICHs did. The SylH patients had a higher incidence of both vasospasm and brain edema. Therefore, physicians must consider differences in clinical features based on hematoma distribution when choosing an appropriate therapeutic approach for patients with ruptured MCA aneurysms and intracranial hematomas.
Texto completo:
Disponible
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Estrés Psicológico
/
Hemorragia Subaracnoidea
/
Encéfalo
/
Edema Encefálico
/
Aneurisma Intracraneal
/
Incidencia
/
Arteria Cerebral Media
/
Hematoma
/
Hidrocéfalo Normotenso
/
Aneurisma
Tipo de estudio:
Estudio de incidencia
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Korean Journal of Cerebrovascular Surgery
Año:
2010
Tipo del documento:
Artículo