https://scholars.lib.ntu.edu.tw/handle/123456789/467751
Title: | Risk profile of patients with poor-grade aneurysmal subarachnoid hemorrhage using early perfusion computed tomography | Authors: | FON-YIH TSUANG JO-YU CHEN CHUNG-WEI LEE Li C.-H. Lee J.-E. DAR-MING LAI Hu F.-C. YONG-KWANG TU SUNG-TSANG HSIEH KUO-CHUAN WANG |
Issue Date: | 2012 | Publisher: | Elsevier Inc. | Journal Volume: | 78 | Journal Issue: | 5 | Start page/Pages: | 455 | Source: | World Neurosurgery | Abstract: | Objective: To determine whether perfusion computed tomography (CT) is useful for identifying patients with poor-grade subarachnoid hemorrhage (SAH) with reversible etiologies and whether early obliteration in patients with poor-grade aneurysmal SAH leads to favorable outcomes. Methods: Patients with new-onset aneurysmal SAH in World Federation of Neurological Surgeons (WFNS) grade IV or V neurologic condition who had perfusion CT performed at admission were eligible for the study. The study retrospectively enrolled 38 patients seen between January 2007 and July 2009. The decision to perform an early obliteration was made by the family after a discussion with the neurosurgeons, neurointensivists, and interventional radiologists. The functional outcomes were correlated with the Glasgow Outcome Scale (GOS) at 6 months, and quantitative perfusion CT data were collected. Results: This study included 10 (26%) grade IV and 28 (74%) grade V patients. Favorable outcomes occurred in 19 (50%) patients, and 11 (29%) patients died. After a multivariate logistic regression analysis of the parameters, older age (odds ratio 1.104, P = 0.0317), bilateral prolonged mean transient time (MTT) at the thalami (odds ratio 4.155, P = 0.0362), and early obliteration (odds ratio 0.098, P = 0.003) were predictive of poor outcome. Conclusions: Early bilateral prolonged MTT at the thalami and old age are associated with a poor outcome. Early obliteration benefits a significant portion of SAH patients. Crown Copyright © 2012 Published by Elsevier Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84868556439&doi=10.1016%2fj.wneu.2011.12.004&partnerID=40&md5=ff363a2e0185fcb382a7a9b080ec2557 https://scholars.lib.ntu.edu.tw/handle/123456789/467751 |
ISSN: | 1878-8750 | DOI: | 10.1016/j.wneu.2011.12.004 |
Appears in Collections: | 解剖學暨細胞生物學科所 |
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