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Titolo:
Initial loss of consciousness and risk of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
Autore:
Hop, JW; Rinkel, GJE; Algra, A; van Gijn, J;
Indirizzi:
Univ Utrecht, Dept Neurol, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Julius Ctr Patient Oriented Res, Utrecht, Netherlands Julius Ctr Patient Oriented Res Utrecht Netherlands trecht, Netherlands
Titolo Testata:
STROKE
fascicolo: 11, volume: 30, anno: 1999,
pagine: 2268 - 2271
SICI:
0039-2499(199911)30:11<2268:ILOCAR>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLATELET THROMBOXANE RELEASE; COMPUTED-TOMOGRAPHY; SURGERY; VASOSPASM; PREDICTION; INFARCTION; OPERATION; RUPTURE; BLOOD; CT;
Keywords:
aneurysm; atherosclerosis; cerebral ischemia; risk factors; subarachnoid hemorrhage;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Hop, JW Univ Utrecht, Dept Neurol, POB 85500, NL-3508 GA Utrecht, Netherlands Univ Utrecht POB 85500 Utrecht Netherlands NL-3508 GA Netherlands
Citazione:
J.W. Hop et al., "Initial loss of consciousness and risk of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage", STROKE, 30(11), 1999, pp. 2268-2271

Abstract

Background and Purpose-Delayed cerebral ischemia (DCI) is a major cause ofdeath and disability in patients with aneurysmal subarachnoid hemorrhage. We studied the prognostic value for DCI of 2 factors: the duration of unconsciousness after the hemorrhage and the presence of risk factors for atherosclerosis,Methods-In 125 consecutive patients admitted within 4 days after hemorrhage, we assessed the presence and duration of unconsciousness after the hemorrhage, the neurological condition on admission, the amount of subarachnoid blood, the size of the ventricles, and a history of smoking, hypertension, stroke, or myocardial infarction. The relationship between these variables and the development of DCI was analyzed by means of the Cox proportional hazards model. Results-The univariate hazard ratio (HR) for the development of DCI in patients who had lost consciousness for >1 hour was 6.0 (95% CI 3.0 to 12.0) compared with patients who had no loss or a <1-hour loss of consciousness. The presence of any risk factor for atherosclerosis yielded an HR of 1.4 (95% CI 0.6 to 3.5), The HR for unconsciousness remained essentially the same after adjustment for other risk factors for DCI, The HR for a poor World Federation of Neurological Surgeons score (grade IV or V) on admission was 2.9 (95% CI 1.5 to 5.5); that for a large amount of subarachnoid blood on CT was 3.4 (95% CI 1.6 to 7.3). Conclusions-The duration of unconsciousness after subarachnoid hemorrhage is a strong predictor for the occurrence of DCI. This observation may contribute to a better understanding of the pathogenesis of DCI and increased attention for patients at risk.

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Documento generato il 13/07/20 alle ore 18:10:07