Subarachnoid Hemorrhage

Bambakidis, Nicholas C.; Selman, Warren R.

doi:10.1007/978-1-59259-660-7_20

Cited by 8 publications

(4 citation statements)

References 74 publications

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“…1,2 Because of rapid clearance of blood, delayed head CT scanning may be normal despite a suggestive history. 3 However, the recently published guidelines by the American Heart Association do not involve the predictors of the SAH on a negative CT scan. 4 This study sought to determine the predictors of the SAH on a negative CT scan.…”

Section: Predictors Of the Subarachnoid Hemorrhage Of A Negative Ct Scanmentioning

confidence: 99%

Predictors of the Subarachnoid Hemorrhage of a Negative CT Scan

Tong

Zhou²

2010

Stroke

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Predictors of the Subarachnoid Hemorrhage of a Negative CT ScanTo the Editor:A good-quality head CT scan will reveal subarachnoid hemorrhage (SAH) in 93% of cases within 24 hours and in Ͼ98% of cases within 12 hours after the onset of symptoms. 1,2 Because of rapid clearance of blood, delayed head CT scanning may be normal despite a suggestive history. 3 However, the recently published guidelines by the American Heart Association do not involve the predictors of the SAH on a negative CT scan. 4 This study sought to determine the predictors of the SAH on a negative CT scan.An inception cohort consisted of 367 patients with SAH admitted to the hospital between August 1995 and December 2008. Third-generation CT scanners were used in all patients. The diagnosis of SAH was established on the basis of admission CT scans or by xanthochromia of the cerebrospinal fluid if the CT scan was negative. The patients with a negative CT scan were divided into an emergency CT scan-negative group (0 to 3 days of onset) and a nonemergency CT scan-negative group (4 to 14 days of onset) and 32 patients were randomized who had SAH according to a positive CT scan (control group) and compared individually. Multiple logistic regression was used to identify predictors of SAH of a negative CT scan. Spearman rank correlation was used to analyze the delayed the time of head CT scan in relation to the score of the CT rating scale.Twenty-three of the 367 patients who had SAH on a negative CT scan were diagnosed by lumbar puncture. Of those, 3.3% (12 of 367) patients were in the emergency CT scan-negative group and 3.0% (11 of 327) patients were in the nonemergency CT scan-negative group. Baseline characteristics of the patients are given in the Table. A multiple logistic regression showed that low Hunt Hess grade (OR, 0.141; 95% CI, 0.031 to 0.636; Pϭ0.011) and normal diastolic blood pressure (OR, 0.917; 95% CI, 0.852 to 0.986; Pϭ0.020) were independent predictors of SAH on a negative emergency CT scan. Delaying the time of CT scan (OR, 3.701; 95% CI, 1.419 to 9.650; Pϭ0.007) was an independent predictor of SAH in the nonemergency CT scan-

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Section: Predictors Of the Subarachnoid Hemorrhage Of A Negative Ct Scanmentioning

confidence: 99%

Predictors of the Subarachnoid Hemorrhage of a Negative CT Scan

Tong

Zhou²

2010

Stroke

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“…314 Because blood can be cleared from CSF spaces relatively rapidly, the sensitivity of CT drops to 50% at 7 days. 315 (a) When the clinical suspicion for SAH is high but CT is negative, lumbar puncture (LP) is indicated, to detect blood in the CSF:…”

Section: Radiographic Work-upmentioning

confidence: 99%

Intracranial Aneurysms and Subarachnoid Hemorrhage

Harrigan

Deveikis

2009

Handbook of Cerebrovascular Disease and Neurointerventional Technique

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“…Aneurysmal subarachnoid hemorrhage (aSAH) is associated with an average mortality rate of 51 %[1]. If untreated, greater than 50% of patients suffer re-rupture with permanent neurologic disability or death; the rate of which is highest in the first two weeks post-ictus [2–4]. Re-rupture rates have been quoted as 4% during the first post-bleed day and 1–2% per day thereafter for the first two weeks[5] with 23.5% of re-ruptures occurring in the first three days [4].…”

Section: Introductionmentioning

confidence: 99%