Short- and long-term outcomes in non-aneurysmal non-perimesencephalic subarachnoid hemorrhage

Lago, Aída; López‐Cuevas, Rogelio; Ji, Tembl; Fortea, Gerardo; Górriz, David; Aparici, Fernando; Parkhutik,

doi:10.1080/01616412.2016.1200306

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Previous studies evaluating the risk of a cerebral aneurysm in developing vasospasm and DCI observed higher likelihood in aneurysmal SAH versus nonaneurysmal SAH (e.g., perimesencephalic SAH) (OR 3.79, p = 0.009) [25]. Our results support this evidence from previous studies as we found that the presence of a cerebral aneurysm was associated with a higher probability of DCI (OR 6.5, p = 0.03), in accordance with what previously published [26]. Moreover, we found that ACOM aneurysm had an additive risk of DCI (OR 9.5, p = 0.026) having the worst disease course compared to other aneurysmal locations.…”

Section: Discussionsupporting

confidence: 93%

Prognostic factors of delayed cerebral ischemia after subarachnoid hemorrhage including CT perfusion: a prospective cohort study

Abdel-Tawab

Hasan

Ahmed

et al. 2020

Egypt J Radiol Nucl Med

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Background: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. This prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, the presence of a cerebral aneurysm, and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess scale > 2, Fisher scale > 2, and MTT of 4.65 s. Conclusion: MTT is a sensitive and specific predictor of DCI. However, Hunt and Hess scale has the optimal sensitivity and specificity to distinguish between patients who developed DCI and clinically stable patients.

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Section: Discussionsupporting

confidence: 93%

Prognostic factors of delayed cerebral ischemia after subarachnoid hemorrhage including CT perfusion: a prospective cohort study

Abdel-Tawab

Hasan

Ahmed

et al. 2020

Egypt J Radiol Nucl Med

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“…Considering SAH-related variables, external CSF drainage was included in the regression analysis, since this has been related to unfavorable outcome in the literature [29,30]. Also, anSAH is generally considered a benign pathology compared to aSAH [31,32], therefore SAH-type was also entered.…”

Section: Methodsmentioning

confidence: 99%

Return to work after subarachnoid hemorrhage: The influence of cognitive deficits

et al. 2019

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Introduction Cognitive deficits are frequently found after subarachnoid hemorrhage (SAH), but their influence on return to work is largely unknown. To improve identification of those patients at-risk for long-term return to work problems, we aimed to examine the value of cognitive deficits in the prediction of long-term return to work after subarachnoid hemorrhage. Methods SAH patients (N = 71) who were employed before SAH and were able to undergo neuropsychological assessment, were included. Demographic characteristics and acute SAH-related variables (SAH-type and external cerebrospinal fluid drainage) were taken into account. Neuropsychological tests for memory, speed, attention, executive function, and emotion recognition and a questionnaire for executive functions were used. Return to work was assessed using the Role Resumption List. Results Results showed that patients with incomplete return to work had significantly lower scores on neuropsychological measures for complex attention and executive functions ( p < 0.05) compared to patients with complete return to work. Return to work could not be significantly predicted using only demographic characteristics and acute SAH-related variables, but adding measures of complex attention and executive functions resulted in a prognostic model that could reliably distinguish between complete and incomplete return to work. Statistically significant predictors in the final model were cerebrospinal fluid drainage and scores on a questionnaire for executive functions: patients with cerebrospinal fluid drainage and higher scores on the a questionnaire for executive functions were less likely to return to work. Discussion Together, these findings show that neuropsychological measures, especially for complex attention and executive functions, have added value to acute SAH-related and demographic variables in the prediction of long-term return to work after SAH.

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“…Повторное кровоизлияние в стационаре описано лишь у 3 из более чем 1 220 проанализированных в литературе случаев ПМСАК, но убедительно документировано лишь у одной 57-летней больной, получавшей антикоагулянты и антиагреганты по поводу острого коронарного синдрома [16]. При выписке из стационара 99% пациентов имеют результат модифицированной шкалы Рэнкин 0-2 балла [8,[17][18][19][20][21][22][23], что отмечено и в нашей работе.…”

Section: Discussionunclassified

Analysis of immediate and long-term outcomes of perimesencephalic subarachnoid hemorrhage according to the hospital register data

et al. 2020

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Introduction. Perimesencephalic subarachnoid hemorrhage (PMSAH) accounts for approximately half of all cases of non-aneurysmal hemorrhage, has a typical pattern on computed tomography (CT) of the brain, and favorable clinical course. Moreover, in the domestic literature there are no studies devoted to this problem.The purpose of the study: to study the frequency of occurrence, clinical and CT features of PMSAH in comparison with nonaneurismatic non-PMSAH according to the hospital register of the regional stroke center.Materials and methods. The data of 383 patients who underwent treatment with a diagnosis of spontaneous SAH in the regional stroke center of Perm Clinical Hospital №4 in 2014–2019 were analyzed. All patients underwent a standard examination, including CT of the brain and digital selective angiography (DSA). According to the pattern of SAH on CT, patients are divided into the groups PM-1 (isolated preptine), PM-2 (traditional) and PM-3 (diffuse). Evaluation of the long-term outcome was carried out using a telephone interview, as well as according to the regional electronic medical system.Results. Of 383 patients with SAH, aneurysms were identified in 350 patients (91,3%). Non-aneurysmal SAH was found in 20 patients (5,2%), in 8 patients (2,1%) − PMSAH. The age of patients averaged 48 years, women predominated. Intense headache in the onset of the disease was observed in the vast majority of patients. Nausea was significantly more often observed in patients with PMSAР (50%) compared with patients with non-PMSAР (8,3%). Loss of consciousness occurred in every fourth patient with PMSAР and only 8% of patients with non-PMSAH. The neurological status of the patients also did not differ and was characterized by a normal consciousness, meningeal syndrome (in 63% of patients with PMSAH) in the absence of focal symptoms. The level of neurological deficit according to NIHSS averaged 0 points, the severity of SAH on the Hunt-Hess scale averaged 2 points. At the time of completion of treatment, most patients did not have a neurological and functional deficit. According to CT, in 4 patients (50%), PM-2 was visualized, in 3 patients (38%) − PM-3, and in one patient − PM-1 (12%). On average, after 15 months, none of the treated patients developed repeated SAH, patients did not have functional limitations.Conclusions. This study for the first time made it possible to characterize the approximate frequency of occurrence, clinical and CT picture, as well as the long-term prognosis of PMSAH in a cohort of patients from a large regional stroke center in Russia.

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Short- and long-term outcomes in non-aneurysmal non-perimesencephalic subarachnoid hemorrhage

Cited by 14 publications

References 21 publications

Prognostic factors of delayed cerebral ischemia after subarachnoid hemorrhage including CT perfusion: a prospective cohort study

Prognostic factors of delayed cerebral ischemia after subarachnoid hemorrhage including CT perfusion: a prospective cohort study

Return to work after subarachnoid hemorrhage: The influence of cognitive deficits

Analysis of immediate and long-term outcomes of perimesencephalic subarachnoid hemorrhage according to the hospital register data

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