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KMID : 1005420060080010026
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Journal of Cerebrovascular and Endovascular Neurosurgery
2006 Volume.8 No. 1 p.26 ~ p.32
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Clinical Analysis of Poor grade Subarachnoid Hemorrhage Patients
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Jo Tae-Yeon
Kim Jong-Hyun
Kim Joo-Han
Kwon Taek-Hyun
Park Youn-Kwan
Chung Heung-Seob
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Abstract
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Purpose: Subarachnoid hemorrhage (SAH) resulting from aneurysmal rupture carries a high rate of morbidity and mortality despite of intensive care. Owing to the advance in surgical techniques, the management results of good grade patients have shown better outcomes than the past, but those of poor grade patients have been still unsatisfactory. The aim of this study is to determine the treatment and the prognostic factors in the poor grade SAH patients.
Method: We have analyzed 43 patients of Hunt & Hess (H&H) grade IV and V among 438 SAH patients treated between 1998 and 2004. The patients were divided into two groups (Good outcome group and Poor outcome group) according to the management outcomes. Each group was analyzed about the various prognosis factors; age, sex, H&H grade, Fisher grade, location and size of aneurysm, timing of operation, and complications.
Results: Among the various factors evaluated, the preoperative H&H grade only showed statistical significance (P value=0.0173). The better H&H grade seemed to show the more favorable outcome, especially surgically treated cases.
Conclusions: An aggressive treatment including early surgery seems to contribute to a better outcome of poor grade SAH patients, especially H&H grade IV. But further clinical study should be researched to improve clinical outcomes in H&H grade V patients.
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KEYWORD
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Poor grade subarachnoid hemorrhage, Good outcome group, Hunt & Hess grade IV, Early surgery
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