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KMID : 0388419990090010127
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Konkuk Journal of Medical Sciences
1999 Volume.9 No. 1 p.127 ~ p.134
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The Clinical Analysis of Prognostic Factors in Traumatic Subarachnoid Hemorrhage
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Paek Il-Seo
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Abstract
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The presence of traumatic subarachnoid hemorrhage on the initial brain computerized tomographic scans are associated with diverse results. Between January 1992 and December 1997, 1857 patients were admitted to our department of neurosurgery due to head injury. Among them, 71 patients had a traumatic subarachnoid hemorrhage on initial brain computed tomography. We analyzed various brain computed tomographic findings, such as thickness and location of
subarachnoid hemorrhage, evidence of mass lesion, midline shift, obliteration of the basal cistern, and cortical sulcal effacement in order to know the relationship to their final outcomes. Additionally age, sex, causes of trauma, initial Glasgow Coma Scale(GCS) score, arterial gas study, systemic blood pressure and prothrombin time, pupillary light
reflex and secondary complication were also analyzed for the same purpose. All the patients were treated with calcium channel blocker and lowering intracranial pressure. All these data were compared to Glasgow outcome scale on discharge, and arbitrarily these were divided into good(good recovery and moderate disability) and bad (severe
disability, vegetative state and death). The author concluded that the contributing factors to outcome at discharge were as
follows: lower GCS score, loss of pupillary light reflex, severe multiple injury, various initial brain computed tomographic finding (subdural hemorrhage, midline shift, obliteration of the basal cistern, cortical sulcal effacement, diffuse subarachnoid hemorrhage, low density in brain stem) and prolongation of prothrombin time were shown to statistically significant.
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KEYWORD
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traumatic subarachnoid hemorrhage, prognostic factor, CT finding, outcome
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