Journal of Korean Neurosurgical Society

  • 제64권4호
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  • Pages.543-551
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  • 2021
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Hypertensive Retinopathy and the Risk of Hemorrhagic Stroke

  • 투고 : 2020.09.28
  • 심사 : 2020.12.14
  • 발행 : 2021.07.01
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초록

Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

키워드

과제정보

I would like to express my sincere gratitude and appreciation to all those who have directly or indirectly aid me in completing this thesis. First and foremost, I would like to express my utmost gratitude and appreciation to my dissertation supervisors Datuk Mr. (Dr.) Pulivendhan Sellamuthu (Head of Department of Neurosurgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah) and Mr. (Dr.) Regunath Kandasamy (Consultant Neurosurgeon, Universiti Sains Malaysia, Kubang Kerian, Kelantan). Their motivation, patience, continuous guidance, and encouragement has brought me towards completing this work. I also would like to take this opportunity to thank the founder of the Neurosurgical Residency training Programme in Universiti Sains Malaysia, Professor Dato' Mr. (Dr.) Jafri Malin Abdullah and Head of Neurosciences Department, Universiti Sains Malaysia, Professor Mr. (Dr.) Zamzuri Idris. Their advices, guidance, and encouragement are invaluable. Special thanks to Miss. Su Lan of Clinical Research Centre Hospital Queen Elizabeth, Kota Kinabalu for their help and guidance in statistics and analysis and Mr (Dr.) Arshad Ali for his contribution towards my thesis. Heartful thanks also expressed to fellow doctor colleagues, especially Dr. Vidya Pillai and Dr. Nishanti Apporrow and nursing staff in the department of neurosurgery in Queen Elizabeth Hospital for their support and help in data collection. I also would like to thank everyone whose name were not mentioned here but has aid, guided, and lent hand in the success of this study. Lastly a special thanks to my wife, Dr. Thivashini for her continuous support to me.

참고문헌

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