Journal of Korean Neurosurgical Society
- 제29권1호
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- Pages.108-112
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- 2000
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
두부외상 후 발생한 지주막하 출혈에 대한 임상분석
A Clinical Analysis on Traumatic Subarachnoid Hemorrhage
- 구태헌 (동국대학교 의과대학 신경외과학교실) ;
- 김한식 (동국대학교 의과대학 신경외과학교실) ;
- 목진호 (동국대학교 의과대학 신경외과학교실) ;
- 이규춘 (동국대학교 의과대학 신경외과학교실) ;
- 박용석 (동국대학교 의과대학 신경외과학교실) ;
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이영배
(동국대학교 의과대학 신경외과학교실)
- Goo, Tae Heon (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
- Kim, Han Sik (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
- Mok, Jin Ho (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
- Lee, Kyu Chun (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
- Park, Yong Seok (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
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Lee, Young Bae
(Department of Neurosurgery, College of Medicine, Dong Guk University)
- 투고 : 1999.05.27
- 심사 : 1999.07.22
- 발행 : 2000.01.28
초록
Objective : Many authors suggest that patients with traumatic subarachnoid hemorrhage(tSAH) visible on first CT after heve injury had a significantly worse prognosis than patients who do not. The aim of this study is to identify patients with tSAH who present with a bad prognosis by reviewing their clinicoradiological features and plan appropriate treatments. Patients and Methods : We reviewed and analysed the factors that influenced discharge outcomes in 172 patients with tSAH for a 3-year period. The outcome was divided into good(good recovery and moderate disability of glasgow outcome scale) and good(severe disability, vegetative state and death). Results : A regression analysis of statistical significant factors(p<0.05) among the clinical and CT features ranked them by descending order of contribution to Glasgow Outcome Scale(GOS) scores at the time of discharge from acute hospitalization as follows 1) clinical : admission Glasgow Coma Scale(GCS), hypotension, CT grade, abnormal APTT, skull fracture, hyperglycemia(>160mg/dl), hypoxia, operation, 2) CT : basal cistern effacement(BCE), mass lesion, cortical sulcal effacement(CSE), midline shift. Conclusion : We have also experienced that the CT grading scale proposed by Green et al is a simple and useful prognostic factor. The authors believe that the patients with high CT grade need adjuvant therapies as of well surgery but it seems mandatory to consider early identification and correction of hypotension, hyperglycemia, and hypoxia in emergency setting.