medigraphic.com
ISSN 2225-4676 (Electronic)

2014, Number 2

<< Back Next >>

Rev Cubana Neurol Neurocir 2014; 4 (2)

Clinical and outcome characteristics associated with rebleeding in aneurismatic subarachnoid hemorrhage

Rivero RD, Scherle MCE, Gutiérrez RÁR, Pérez NJ, Gómez VN

Language: Spanish
References: 19
Page: 124-129
PDF size: 290.48 Kb.


ABSTRACT

Objective: To evaluate clinical and outcome characteristics of patients with rebleeding after aneurismatic subarachnoid hemorrhage.
Methods: An observational, retrospective cohort study was made, in patients treated by subarachnoid hemorrhage at the Hermanos Ameijeiras´s Hospital, in Havana City, Cuba, since October 2005 until December 2012.
Results: The more frequent location of the aneurism was the posterior communicant artery, followed by the anterior communicant. There was a significant association in patients with history of arterial hypertension (p=0.011), with an increase of the mortality (Rankin 6, p=0.000). In patients with subarachnoid rebleeding most aneurism were located in anterior circulation arteries (52/88.1 % of 59), mainly in anterior communicant artery (25/42.4 %) followed by posterior communicant artery (16/27.1 %). In non-rebleeding group the aneurisms were located mainly in carotid sector (96.5 %) and more frequent in posterior communicant artery (84/36.7 %) followed by anterior communicant artery (67/29.2 %). The surgical treatment was delayed in patients with rebleeding (16.6 days), compare with the other group of patients (12.2 days), but the difference was not significant (p=0.085).
Conclusions: Patients with rebleeding after aneurismatic subarachnoid hemorrhage was characterized by arterial hypertension´s history, higher mortality, disability and assistance in intensive unit service.


REFERENCES

  1. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355–69.

  2. Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA. Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003. Neurosurg. 2007;61:1131–7.

  3. Dirección nacional de registros médicos y estadísticas de salud. Anuario estadístico de salud 2012 [Monografía en Características clínicas y evolutivas asociados al resangrado en la hemorragia subaracnoidea aneurismática Rev Cubana Neurol Neurocir. 2014;4(2):124–9 129 Internet]. La Habana, abril 2012 [citado: 1.02.2014]. Disponible en: http://www.sld.cu/servicios/estadisticas

  4. Rodríguez García PL, Rodríguez García D. Hemorragia subaracnoidea: epidemiología, etiología, fisiopatología y diagnóstico. Rev Cubana Neurol Neurocir. [Internet] 2011 [citado 1.02.2014];1(1):59–73. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/11

  5. González Aguirre Y, Varela Hernández A, Casares Albernas F, Herrera Lorenzo O, Infante Ferrer J, Morgado Castañeda R. Comportamiento de la hemorragia subaracnoidea espontánea en el Hospital Universitario “Manuel Ascunce Domenéch”. Rev Cubana Neurol Neurocir. [Internet] 2012 [citado 1.02.2014];2(1):17–22. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/32

  6. González González JL, Hernández Zayas H, Brown Jaquinet E, De Jongh Cobo E, Gómez Viera N. Factores que influyen sobre los resultados del tratamiento quirúrgico en aneurismas de la arteria Cerebral Media (Hospital Hermanos Ameijeiras 1983-2004) Rev Cubana Cirugía. 2007;46(3).

  7. Starke RM, Connolly ES Jr. Rebleeding After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care. 2011;15(2):241–6.

  8. González González HL. Hemorragia subaracnoidea aneurismática. En: Rodríguez SH, eds. Manual de Prácticas Médicas. H.C.Q. Hermanos Ameijeiras. 2 ed. La Habana 2008. Disponible en: http://www.hospitalameijeiras.sld.cu/hha/mpm/documentos/NEUROCIRUGIA/PA/HEMORRAGIA%20SUBARACNOIDEA%20ANEURISMATICA.pdf [1.02.2014].

  9. Rosen DS, Macdonald RL. Grading of subarachnoid hemorrhage: modification of the World Federation of Neurosurgical Societies scale on the basis of data for a large series of patients. Neurosurgery. 2004;54:566-75.

  10. Rankin J. Cerebral vascular accidents in patients over the age of 60, II: Prognosis. Scout Med J. 1957;2:200-5.

  11. Tanno Y, Homma M, Oinuma M, Kodama N, Yamamoto T. Rebleeding from ruptured intracranial aneurysms in North Eastern Province of Japan: a cooperative study. J Neurol Sci. 2007; 258:11-16.

  12. Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta–analysis. Lancet Neurol. 2009;8:635–42.

  13. Naidech AM, Ianjua N, Kreiter KT, Ostapkovich ND, Fitzsimmons BF, Parra A, et al. Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage. Arch Neurol. 2005;62(3):410–6.

  14. Dusak A, Kamasak K, Goya C, Adin ME, Elbey MA, Bilici A. Arterial distensibility in patients with ruptured and unruptured intracranial aneurysms: Is it a predisposing factor for rupture risk? Med Sci Monit. 2013;19:703-9.

  15. Ohkuma H, Tsurutani H, Suzuki S. Incidence and significance of early aneurysmal rebleeding before neurosurgical or neurological management. Stroke. 2001;32(5):1176-80.

  16. Ferro JM, Canhão P, Peralta R. Update on subarachnoid haemorrhage. J Neurol. 2008;255:465–79.

  17. Kassell NF, Kongable GL, Torner JC, Adams HP, Mazuz H. Delay in referral of patients with ruptured aneurysms to neurosurgical attention. Stroke. 1985;16:587-90.

  18. Pérez Nellar J, Scherle Matamoros C, Montes de Oca F, González González J, Hierro García D. Demora en la llegada de pacientes con hemorragia subaracnoidea a un hospital terciario. Rev Neurol. 2009;49 (10):524-8.

  19. Connolly ES, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1-27.




2020     |     www.medigraphic.com