医学
格拉斯哥结局量表
蛛网膜下腔出血
剪裁(形态学)
外科
神经外科
动脉瘤
梗塞
脑出血
放射科
格拉斯哥昏迷指数
心脏病学
心肌梗塞
语言学
哲学
作者
Alok Umredkar,Sunil Gupta,Niranjan Khandelwal,Rajesh Chhabra,Suresh N. Mathuriya,Ashish Pathak,M. K. Tiwari,Kanchan K. Mukherjee,Sandeep Mohindra,Navneet Singla,Praveen Salunke
标识
DOI:10.3109/02688690903513412
摘要
Subarachnoid hemorrhage (SAH) is a significant health care problem. One of the major determinants of outcome following surgery of intracranial aneurysms is development of intracranial infarcts. All patients underwent clipping for aneurysms in one year in the department of neurosurgery, PGIMER, Chandigarh were studied. Data regarding age, sex, date of ictus, date of admission, any co-morbidity, clinical grades at presentation, CT findings, infarcts, intraoperative rupture, and clinical status in the postoperative period were recorded. Outcome at discharge was assessed by Glasgow outcome scale (GOS). First, 174 patients were included in the study. Radiological cerebral infarctions occurred in 69 patients (39%). The most frequent location of infarct was deep perforator infarct followed by ACA territory infarct. 69.58% of patients developed infarct on the same side of aneurysm and 20.28% of patients developed infarct on opposite side, whereas 11% developed bilateral infarcts. Infarcts that occur early after surgery may be related to surgical factors whereas the late infarcts were probably as results of delayed ischemic deficits. Anatomical distribution of infarcts also showed two different patterns, infarcts limited to one vascular territory (more commonly seen in early onset infarcts) or multiple, cortical, bilateral infarcts (more commonly seen in late onset infarct). Patients with poor H&H grade, higher Fisher's grade, intraoperative rupture and prolonged temporary clipping had more chances of developing an intracranial infarct.
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