Intracranial pressure levels and single wave amplitudes, Glasgow Coma Score and Glasgow Outcome Score after subarachnoid haemorrhage

Abstract OBJECTIVE: Proximal posterior inferior cerebellar artery (PICA) aneurysms represent a subset of posterior circulation aneurysms that can be routinely treated with either clipping or coiling. The literature contains limited numbers of patients with proximal PICA aneurysms treated with endovascular surgery. We report our experience with endovascular surgery of proximal PICA aneurysms with emphasis on patients with poor Hunt-Hess grades. METHODS: We reviewed 31 consecutive patients with proximal PICA aneurysms who were treated with endovascular surgery. The following data were analyzed: age, sex, size of aneurysm, Hunt-Hess grade at presentation, Fisher grade at presentation, angiographic result after embolization, complications, number of days hospitalized, duration of follow-up, angiographic follow-up results, and Glasgow Outcome Score at follow-up. RESULTS: Excellent angiographic occlusion was achieved in 30 of 31 (97%) patients. Clinical follow-up with Glasgow Outcome Score was performed on every patient an average of 10 months later. Twenty-one of 31 (68%) patients had good outcomes (Glasgow Outcome Score I or II) at follow-up. Of the patients who presented with a favorable clinical grade (Hunt-Hess 0–III), 13 of 15 (87%) had good outcomes at follow-up. Of the patients who presented with a poor clinical grade (Hunt-Hess Grade IV or higher), 8 of 16 (50%) had good outcomes at follow-up. CONCLUSION: This series demonstrates the safety and efficacy of endovascular surgery for proximal PICA aneurysms. Many patients with poor Hunt-Hess grades from ruptured PICA aneurysms ultimately had a good outcome. This could be secondary to early, aggressive treatment of hydrocephalus and the minimally invasive nature of the endovascular approach.

Download Full-text

Determine the Outcome of Traumatic Extradural Hematoma and to Compare the Outcome of Small and Large Size Extradural Hematoma

10.53350/pjmhs2115103363 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3363-3365

Author(s):

Muhammad Pervez Khan ◽

Muhammad Anwar

Keyword(s):

Glasgow Outcome Score ◽

Extradural Hematoma ◽

Hematoma Volume ◽

Common Cause ◽

Descriptive Case Study ◽

Large Size ◽

Outcome Score ◽

Male Patients

Objective: The aim of this study is to determine the outcome of traumatic extradural hematoma and to compare the outcome of small and large size extradural hematoma. Study Design: Descriptive case study Place and Duration: Study was conducted at the department of Neurosurgery, Saidu Teaching Hospital, Saidu Sharif, Swat for duration of two years from January 2016 to December 2017. Methods: Total one hundred and forty patients of both genders with ages 2-70 years were presented. Patients had traumatic extradural hematoma within duration first 24 hours were included and admitted through the emergency department. Detailed demographics of enrolled cases age, sex, GCS on arrival and cause of injury were recorded after taking informed written consent. CT scan of all the patients was done for diagnosis. Glasgow Outcome Score (GOS) was used for determination of outcomes. SPSS 23.0 version was used to analyze the data. Results: There were 110 (78.6%) male patients and 30 (21.4%) patients were females. Mean age of the patients was 32.78±10.43 years. RTA was the most common cause found in 84 (60%) followed by falling 29 (20.7%) and assault in 27 (19.3%). Small size hematoma volume among 100 (71.4%) cases and large size was in 40 (28.6%) patients. According to Glasgow outcome score, 24 (17.1%) cases had 1-3 score and 116 (82.9%) cases had 4-5 score. Mean GOS was 4.01±1.12. We found successful outcomes among 116 (82.9%) cases in which majority of the patients were from small size extradural hematoma. Conclusion: We concluded in this study that a significant relationship exists between the volume of extradural hematoma and both the clinical and functional outcome. Prognosis becomes increasingly worse with rising extradural hematoma size. Keywords: Traumatic Brain Injury, Extradural Hematoma, Glasgow Outcome Score

Download Full-text

Neurologic Emergencies (DRAFT)

10.1093/med/9780190650261.003.0023 ◽

2018 ◽

Author(s):

Tamara Kaplan ◽

Tracey Milligan

Keyword(s):

Status Epilepticus ◽

Intracranial Pressure ◽

Subarachnoid Haemorrhage ◽

Vascular Malformation ◽

Reversible Cerebral Vasoconstriction Syndrome ◽

Increased Intracranial Pressure ◽

Cerebral Vasoconstriction ◽

Neurologic Emergencies

The video in this chapter discusses neurologic emergencies, including the symptoms of increased intracranial pressure leading to herniation, subarachnoid haemorrhage (can be due to aneurysm, vascular malformation, or reversible cerebral vasoconstriction syndrome, and definition and management of status epilepticus.

Download Full-text

Neurology

10.1093/med/9780199696277.003.0005 ◽

2013 ◽

Cited By ~ 3

Author(s):

Martin Beed ◽

Richard Sherman ◽

Ravi Mahajan

Keyword(s):

Traumatic Brain Injury ◽

Intensive Care ◽

Status Epilepticus ◽

Brain Injury ◽

Intracranial Pressure ◽

Subarachnoid Haemorrhage ◽

Metabolic Disorders ◽

Raised Intracranial Pressure ◽

Thromboembolic Stroke ◽

Neurological State

Decreased consciousnessSeizures and status epilepticusStroke/thromboembolic strokeIntracerebral haemorrhageSubarachnoid haemorrhageTraumatic brain injuryRaised intracranial pressureMeningitis and encephalitisAgitation/confusion/aggressionAlcohol withdrawalNeuromuscular weakness and paralysisGuillain–Barré syndromeMyasthenia gravis↓consciousness occurs in many diseases requiring admission to intensive care, and is often a cause for admission in its own right. Changes in neurological state may be related to intracranial pathology, or may occur in response to respiratory, circulatory, or metabolic disorders....

Download Full-text