One-year prognosis of non-traumatic cortical subarachnoid haemorrhage: A prospective series of 34 patients.
Por:
Galiano Blancart RF, Fortea G, Pampliega Pérez A, Martí S, Parkhutik V, Sánchez Cruz AV, Soriano C, Geffner Sclarsky D, Pérez Saldaña MT, López Hernández N, Beltrán I, Lago Martín A and por el Grupo Ictus-Comunidad Valenciana
Publicada:
11 jun 2018
Ahead of Print:
11 jun 2018
Resumen:
INTRODUCTION: Cortical subarachnoid haemorrhage (cSAH) has multiple
aetiologies. No prospective study has reported the long-term progression
of the condition. The objective of this study is to describe the
clinical and aetiological characteristics of patients with cSAH and to
gain insight into prognosis.
METHODS: We performed a prospective, observational, multi-centre study.
Data on clinical and radiological variables were collected; during a
one-year follow-up period, we recorded data on mortality, dependence,
rebleeding, and the appearance of dementia.
RESULTS: The study included 34 patients (mean age, 68.3 years; range,
27-89). The most frequent symptoms were headache and focal neurological
deficits, which were frequently transient and recurrent. CT scans
returned pathological findings in 28 patients (85%). Brain MRI scans
were performed in 30 patients (88%), revealing acute ischaemia in 10
(29%), old haemorrhage in 7 (21%), and superficial siderosis in 2 (6%).
Aetiology was identified in 26 patients (76.5%): causes were cerebral
amyloid angiopathy in 8, ischaemic stroke in 5, vasculitis in 4,
reversible posterior encephalopathy in 2, venous thrombosis in 2,
reversible cerebral vasoconstriction syndrome in 2, carotid occlusion in
1, Marfan syndrome in 1, and meningeal carcinomatosis in 1. Three
patients died during follow-up (2 due to causes related to the cause of
cSAH). Three patients developed dementia, 3 had lobar haemorrhages, and
one had a second cSAH.
CONCLUSIONS: The most frequent causes of cSAH in our series were
cerebral amyloid angiopathy, ischaemic stroke, and vasculitis. This type
of haemorrhage has a worse prognosis than other non-aneurysmal cSAH.
There are numerous possible causes, and prognosis depends on the
aetiology. In elderly patients, intracranial haemorrhage is frequently
associated with cognitive impairment.
Filiaciones:
Galiano Blancart RF:
Servicio de Neurología, Hospital Dr. Peset, Valencia, España
Fortea G:
Servicio de Neurología, Hospital La Fe, Valencia, España
:
Servicio de Neurología, Hospital General de Alicante, Alicante, España
:
Servicio de Neurología, Hospital General de Alicante, Alicante, España
Parkhutik V:
Servicio de Neurología, Hospital La Fe, Valencia, España
Sánchez Cruz AV:
Servicio de Neurología, Hospital de Sagunto, Sagunto, España
Soriano C:
Servicio de Neurología, Hospital General de Castellón, Castelló de la Plana, España
Geffner Sclarsky D:
Servicio de Neurología, Hospital General de Castellón, Castelló de la Plana, España
Pérez Saldaña MT:
Hospital de Manises, Manises, España
:
Servicio de Neurología, Hospital General de Alicante, Alicante, España
:
Servicio de Neurología, Hospital General de Alicante, Alicante, España
Lago Martín A:
Servicio de Neurología, Hospital La Fe, Valencia, España
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