Department of Neurosurgery, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
Acta Neurochir (Wien). 2010 Mar;152(3):409-16. doi: 10.1007/s00701-009-0518-8. Epub 2009 Sep 26.
Nonaneurysmal subarachnoid hemorrhage (SAH) is an uncommon form of SAH. As nonaneurysmal SAH is often concentrated around the pons and midbrain, the term perimesencephalic SAH (pmSAH) is widely accepted to describe this entity, though there are patients with a more widespread distribution of subarachnoid blood (non-pmSAH). The outcome of pmSAH is commonly regarded as good, although often outcome is not analyzed using standardized tools of outcome measurement. In this study we focused on the patient's quality of life after nonaneurysmal SAH.
We included 26 patients in this study who experienced a nonaneurysmal SAH between 2003 and 2007. Neurological status upon admission as well as on discharge was recorded. All patients received a detailed postal questionnaire on their current neurological situation, dependence on care (Barthel Index), quality of life regarding their physical and psycho-social well-being (Short-form 36) and current employment situation and ability to work, respectively.
After 32.68 +/- 19.81 months, almost all patients achieved a Glasgow Outcome Score of 4 or 5 and a Barthel Index of more than 90, although there was a difference between patients suffering from pmSAH and patients with non-pmSAH. Physical and social functioning recovered to almost normal levels but vitality and individual health were often perceived as reduced in self-evaluation.
Nonaneurysmal SAH is a begnin entity, though there is a difference between pmSAH and non-pmSAH in outcome. Self-evaluations of vitality and individual health in both groups are often experienced as reduced, thus imposing the question of whether neurological rehabilitation should be recommended despite good neurological outcome.
非动脉瘤性蛛网膜下腔出血(SAH)是一种少见的 SAH 形式。由于非动脉瘤性 SAH 常集中在脑桥和中脑周围,因此广泛接受术语“中脑周围 SAH(pmSAH)”来描述这种情况,尽管也有蛛网膜下腔血液分布更广的患者(非 pmSAH)。pmSAH 的预后通常被认为较好,尽管通常不使用标准化的预后评估工具来分析预后。在本研究中,我们关注非动脉瘤性 SAH 后患者的生活质量。
我们纳入了 2003 年至 2007 年间经历非动脉瘤性 SAH 的 26 例患者。入院时和出院时记录神经状态。所有患者均收到详细的邮寄问卷,内容涉及当前神经状况、对护理的依赖(巴氏指数)、身体和心理社会健康方面的生活质量(36 项简短健康调查),以及当前就业状况和工作能力。
32.68 +/- 19.81 个月后,几乎所有患者的格拉斯哥预后评分均为 4 或 5,巴氏指数均大于 90,尽管 pmSAH 患者和非 pmSAH 患者之间存在差异。身体和社会功能恢复到几乎正常水平,但活力和个体健康在自我评估中常被认为降低。
非动脉瘤性 SAH 是一种良性疾病,但 pmSAH 和非 pmSAH 在预后方面存在差异。两组患者的活力和个体健康的自我评估常被认为降低,因此,尽管神经功能预后良好,是否应推荐进行神经康复治疗仍存在疑问。