Terson sign:

2020 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Luiz Severo Bem Junior ◽  
Gustavo De Souza Andrade ◽  
Joao Ribeiro Memória Júnior ◽  
Hildo Rocha Cirne de Azevedo Filho
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Early Recognition ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Reports ◽  
Clinical Status ◽  
Vitreous Hemorrhage ◽  
Anterior Communicating Artery ◽  
Inclusion Criteria ◽  
Relationship Of ◽  
The Relationship

Terson's sign (TS) is classically defined as vitreous hemorrhage associated with subarachnoid hemorrhage of aneurysmal origin, being an important predictor of severity, indicating greater morbidity and mortality when compared to patients without the sign. The objective of this study is to review the relationship of Terson syndrome/Terson sign with the prognosis of aneurysmal subarachnoid hemorrhage. A search for original articles, research and case reports was performed on the PubMed, Scielo, Cochrane and ScienceDirect platform, with the following descriptors: Terson sign and subarachnoid hemorrhage. Retrospective, prospective articles and case reports published in the last 5 years and which were in accordance with the established objective and inclusion criteria were selected. Ten (10) articles were selected, in which the available results show an unfavorable prognostic relationship of TS and subarachnoid hemorrhage, because these patients had a worse clinical status assessed on the Glasgow scales ≤ 8, Hunt & Hess > III, Fisher > 3, in addition to intracranial hypertension and location of the aneurysm in the anterior communicating artery complex. The early recognition of this condition described by Albert Terson in 1900 brought an important contribution to neurosurgery, being recognized until nowadays.

Antifibrinolytic therapy in the acute period following aneurysmal subarachnoid hemorrhage

1984 ◽  
Vol 61 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Neal F. Kassell ◽  
James C. Torner ◽  
Harold P. Adams
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Aneurysm Surgery ◽  
Cooperative Study ◽  
Content Type ◽  
Antifibrinolytic Therapy ◽  
Rebleeding Rate ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ Antifibrinolytic therapy remains a controversial issue in the management of subarachnoid hemorrhage (SAH). The relationship of antifibrinolytic therapy with mortality, rebleeding, ischemia, hydrocephalus, and clotting abnormalities was studied in 672 patients in the International Cooperative Study on the Timing of Aneurysm Surgery. The patients with antifibrinolytic therapy had a significantly lower rebleeding rate, but higher rates of ischemic deficits and hydrocephalus. The net result was no difference in mortality in the 1st month following the initial SAH. Further clinical trials are needed to determine the overall effects of antifibrinolytic therapy.

scholarly journals Vasospasm following aneurysmal subarachnoid hemorrhage: Thrombocytopenia a marker

2013 ◽  
Vol 04 (03) ◽  
pp. 257-261 ◽  
Author(s):  
Ashish Aggarwal ◽  
Pravin Salunke ◽  
Harnarayan Singh ◽  
Harnarayan Singh ◽  
Sunil Kumar Gupta ◽  
...  
Keyword(s):  
Platelet Count ◽  
Subarachnoid Hemorrhage ◽  
Odds Ratio ◽  
Clinical Symptoms ◽  
Independent Predictor ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Platelet Counts ◽  
Symptomatic Vasospasm ◽  
Relationship Of ◽  
The Relationship

ABSTRACT Background: Symptomatic vasospasm (SV) is often seen after aneurysmal subarachnoid hemorrhage (aSAH). The pathophysiology suggests that platelets initiate the process and are consumed. This is likely to result in thrombocytopenia. The objective of this study was to find out if thrombocytopenia preceded or followed SV and to analyze the relationship between the two. Materials and Methods: The platelet counts of 74 patients were studied on day 1, 3, 5, 7, 9, 11, and 14 following aSAH. Clinical symptoms and raised velocities on transcranial Doppler were studied on the same days to determine SV. The relationship of platelet counts and SV were analyzed. Results: Thirty-nine (52.7%) patients developed SV. Platelet counts dropped on postictal day (PID) 3-7 and SV was commonly seen on PID 5-9. The median platelet counts were significantly lower in patients with SV when compared to those without SV. Platelet count <150,000/mm 3 on PID 1 and 7 had statistically significant association (P < 0.001) with SV. The odds ratio was 5.1, 6.9, and 5.1 on PID 5, 7, and 9, respectively, for patients with relative thrombocytopenia (P < 0.001). Conclusions: There is a strong correlation between thrombocytopenia and SV. A platelet count < 150,000/mm 3 on PID 1 and 7 predicts presence of SV. The relative risk of developing SV is >5 times for a patient with relative thrombocytopenia especially on PID 5-9. Additionally, it appears that thrombocytopenia precedes vasospasm and may be an independent predictor. However, this requires further studies for validation.

scholarly journals Mechanical ventilation in aneurysmal subarachnoid hemorrhage: systematic review and recommendations

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
James E. Towner ◽  
Redi Rahmani ◽  
Christopher G. Zammit ◽  
Imad R. Khan ◽  
David A. Paul ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Subarachnoid Hemorrhage ◽  
Team Member ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Reports ◽  
Inclusion Criteria ◽  
Medical Subject Headings ◽  
Case Control Studies ◽  
Mesh Terms

Abstract Objective Mechanical ventilation (MV) has a complex interplay with the pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH). We aim to provide a review of the physiology of MV in patients with aSAH, give recommendations based on a systematic review of the literature, and highlight areas that still need investigation. Data sources PubMed was queried for publications with the Medical Subject Headings (MeSH) terms “mechanical ventilation” and “aneurysmal subarachnoid hemorrhage” published between January 1, 1990, and March 1, 2020. Bibliographies of returned articles were reviewed for additional publications of interest. Study selection Study inclusion criteria included English language manuscripts with the study population being aSAH patients and the exposure being MV. Eligible studies included randomized controlled trials, observational trials, retrospective trials, case-control studies, case reports, or physiologic studies. Topics and articles excluded included review articles, pediatric populations, non-aneurysmal etiologies of subarachnoid hemorrhage, mycotic and traumatic subarachnoid hemorrhage, and articles regarding tracheostomies. Data extraction Articles were reviewed by one team member, and interpretation was verified by a second team member. Data synthesis Thirty-one articles met the inclusion criteria for this review. Conclusions We make recommendations on oxygenation, hypercapnia, PEEP, APRV, ARDS, and intracranial pressure monitoring.

The relationship of subarachnoid hemorrhage and the need for postoperative shunting

1997 ◽  
Vol 86 (3) ◽  
pp. 462-466 ◽  
Author(s):  
Fernando L. Vale ◽  
Edwin L. Bradley ◽  
Winfield S. Fisher
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Channel Blockers ◽  
Chronic Hydrocephalus ◽  
Content Type ◽  
Vp Shunt ◽  
Significant Relationships ◽  
Brain Relaxation ◽  
Relationship Of ◽  
The Relationship

✓ The incidence of chronic hydrocephalus requiring shunting after aneurysmal subarachnoid hemorrhage (SAH) is not precisely known. The authors investigated whether the need for ventriculoperitoneal (VP) shunting can be predicted by initial Hunt and Hess grade or Fisher computerized tomography score. One hundred eight patients who presented with SAH and underwent 116 surgical procedures for aneurysm clipping were evaluated retrospectively to determine the incidence of chronic hydrocephalus. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after the original hemorrhage and that required shunting. All SAH patients were managed in a similar fashion with induced hypervolemia, relative hemodilution, and hypertension complemented by a course of calcium channel blockers. The majority of patients underwent perioperative extracranial ventricular drainage to allow intraoperative brain relaxation and to assist intracranial pressure management. The overall mortality rate of the study group was 17%. Of the surviving patients, 20% underwent VP shunt placement secondary to chronic hydrocephalus. There were no statistically significant relationships between chronic hydrocephalus and patient age or gender, aneurysm type and size, or use of a perioperative drain. There was a high clinical correlation between chronic hydrocephalus and admission Hunt and Hess grades and Fisher grades (p < 0.05). All of the patients who survived a second bleeding episode and almost 46% of the patients who presented with intraventricular hemorrhage required placement of a VP shunt. The authors present predictive tables of chronic hydrocephalus based on the patient's admission Hunt and Hess grade and Fisher classification.

scholarly journals HUBUNGAN PAPARAN PORNOGRAFI MELALUI TELEVISI DENGAN PERILAKU SEKSUAL REMAJA SMA NEGERI 2 KENDARI

2018 ◽  
Vol 10 (2) ◽  
pp. 15-20
Author(s):  
Yustiari Yustiari ◽  
Syahrianti Syahrianti
Keyword(s):  
Sexual Behavior ◽  
Electronic Media ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Use Of Technology ◽  
Television Media ◽  
Relationship Of ◽  
The Relationship

The use of technology nowadays increasingly facilitates communication without being limited by space and time. At present print and electronic media is an environment that is close to teenagers. Television is an electronic media that is easily accessible to teenagers because of the large amount of information and news broadcast. This study aims to determine the relationship of exposure to pornography through television with teenage sexual behavior of SMAN 2 Kendari. Type of research is analytical, with the research design used is the Cross Sectional Study. The research sample was 69 people. With the inclusion criteria willing to take part in the study by signing the consent sheet and being a teenager attending school at SMAN 2 Kendari. Most respondents 36 people (53.1%) had exposure to pornography from low television media. Mild sexual behavior of 60 respondents (86.96%). The majority of sexual behavior that respondents often do when their boyfriend is holding hands 40 (57.9%). A total of 5 respondents (7.2%) did kisses involving the tongue during dating. Most respondents have peer behavior that is low (57.9%). Based on the results of the study there is a significant relationship between exposure to pornography from television media and teenage sexual behavior (p<0.05).

scholarly journals THE RELATIONSHIP OF BASIC CLINICAL STATUS WITH THE QUALITY OF LIFE OF HIV AND AIDS PATIENTS

2020 ◽  
Vol 8 (3) ◽  
pp. 246
Author(s):  
Lilis Masyfufah ◽  
Erwin Astha Triyono
Keyword(s):  
Quality Of Life ◽  
Smoking Status ◽  
Clinical Status ◽  
Immune Deficiency Syndrome ◽  
Hiv And Aids ◽  
Cd4 Count ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background: The success of individual antiretroviral drug (ARV) treatment in patients with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) was determined by conducting a routine evaluation of the patients’ Cluster of Differentiation 4 (CD4) count. The indicators used to measure the success of the HIV and AIDS treatment were mortality, mobility, and quality of life (QoL). Purpose: The purpose of this research was to analyze the relationship between clinical status (smoking status, duration of ARV therapy, the CD4 count, and body mass index [BMI]) and the QoL of patients with HIV and AIDS who were stable during treatment. Methods: This type of research was quantitative analytical research with a cross-sectional design. This research was conducted at Dr. Soetomo Hospital, Surabaya, from September to November 2017. The study population was patients with HIV and AIDS in Dr. Soetomo Hospital, Surabaya. The research sample was taken by purposive sampling with the inclusion criteria being patients with HIV and AIDS who had been treated for ≥6 months with adherence ≥95% and who came directly to the hospital. Results: The majority of respondents were female (53.36%), junior/senior high school graduates (66.67%), married (62.22%), non-smoking (75.56%), had undergone ARV therapy for ±10 years (77.78%), and had a QoL in the adequate category (62.22%). The basic clinical status with a significant relationship with the respondents’ QoL were the CD4 count (p = 0.00) and BMI (p = 0.00). Conclusion: There was a relationship of the CD4 count and BMI with the QoL of the patients with HIV and AIDS.

THE RELATIONSHIP OF PLACENTAL THICKNESS WITHGESTATIONALAGE IN THIRD TRIMESTER AND PROBABLE FETAL OUTCOME

2021 ◽  
pp. 64-66
Author(s):  
Sambhunath Bandyopadhyay ◽  
Ritayan Sasmal ◽  
Debarshi Jana
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Age Determination ◽  
Fetal Outcome ◽  
Inclusion Criteria ◽  
Third Trimester ◽  
Relationship Of ◽  
The Relationship ◽  
Placental Thickness

Accurate gestational age determination is very important for management of continuation and termination planning of the pregnancy. rd To establish placental thickness as a parameter for determination of gestational age and fetal growth pattern at 3 trimester. 100 primigravida women who are fullling the inclusion criteria and attend gynae &obs OPD or admitted in their third trimester at IPGME&R from January 2017 to june 2018. Placental thickness at 3rd trimester USG scan is moderately correlated with gestational age, if placental thickness expressed in millimeter then it correlated with gestational age at weeks. rd st Placental thickness with >3.2 cm (32 mm) at 3 trimester almost associated with good fetal outcome, with APGAR score >8 at 1 min and birth weight >2500 gm.

Abstract P823: Evaluating Time-To-Aneurysm Repair as a Performance Measure in Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Tiffany O Sheehan ◽  
Nicolle W Davis ◽  
Yi Guo ◽  
Debra Lynch Kelly ◽  
Saun-joo Yoon ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Performance Metrics ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Patient Characteristics ◽  
Performance Measure ◽  
Hospital Death ◽  
Discharge Data ◽  
Stroke Center ◽  
Aneurysm Repair ◽  
The Relationship

Background: Implementation of evidence-based performance metrics drive standardized care and improve patient outcomes. Limited performance metrics have been developed for implementation in the aneurysmal subarachnoid hemorrhage (aSAH) population. Timely aneurysm repair following an aSAH is associated with rebleeding prevention and mortality. The purpose of this study was to evaluate time to aneurysm repair as a candidate performance metric by testing a model that includes hospital and patient characteristics as predictors of time to aneurysm repair and mortality, with time to aneurysm repair as a potential influence on these relationships in aSAH. Methods: A retrospective, cross-sectional analysis of patient discharge data from 2014 in the state of Florida was conducted. Data were derived from The Agency for Healthcare Research and Quality, HealthCare Utilization Project, State Inpatient Dataset, and the American Hospital Association Annual Survey. Patients with a primary ICD-9 diagnosis of aSAH and principle procedure of clipping or coiling were included (n=387). The study outcome was in-hospital mortality. Independent variables were level of stroke center, age, race, sex, and type of aneurysm repair. Hierarchical logistic regression was used to estimate the probability of in-hospital death. Results: Patients who underwent endovascular repair of an aneurysm were more likely to be treated in <24 hours compared to those undergoing aneurysm clipping (OR = 0.54, CI = .35-.84, p =0.01). Patients treated at a comprehensive stroke center (CSC) had a 72% reduction in odds of death compared to those treated at primary stroke centers (OR =0.28, CI = 0.10-0.77, p =0.01), controlling for disease severity and comorbidity. Time to aneurysm repair was not significantly associated with mortality and did not influence the relationship between hospital and patient characteristics and mortality. Conclusions: Treatment at a certified CSC was the only significant predictor of surviving aSAH. Time to aneurysm repair did not influence the relationship between hospital and patient characteristics associated with mortality. Further research is needed to identify appropriate measures and to define what should be tracked for performance in the aSAH population.

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