Coelho Luís Guilherme Bastos Silva Aguiar, Costa José Manuel Dias, Silva Elsa Irene Peixoto Azevedo
Departamento de Neurorradiologia, Centro Hospitalar de São João, Porto, Portugal.
Departamento de Neurologia, Centro Hospitalar de São João, Porto, Portugal.
Rev Bras Ter Intensiva. 2016 Jun;28(2):141-6. doi: 10.5935/0103-507X.20160028.
To compare the clinical evolution of perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage.
The study was conducted retrospectively in a tertiary hospital center in the north region of Portugal. Included patients had no identifiable cause for subarachnoid hemorrhage. Several epidemiologic, clinical and imaging aspects were statistically analyzed, taking into account the differences in perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage.
Sixty-two patients met the inclusion criteria (46.8% - perimesencephalic subarachnoid hemorrhage; 53.2% - non-perimesencephalic subarachnoid hemorrhage). Demographic and clinical background characteristics were similar in both groups. Complications were more frequent in patients with non-perimesencephalic subarachnoid hemorrhage - 84.8% of the patients had at least one complication versus 48.3% in perimesencephalic subarachnoid hemorrhage. Vasospasm, infection and hydrocephaly were the most common complications (each was detected more frequently in the non-perimesencephalic subarachnoid hemorrhage group than in perimesencephalic subarachnoid hemorrhage group). Two patients died, both had a non-perimesencephalic subarachnoid hemorrhage. The median inpatient time was longer in the non-perimesencephalic subarachnoid hemorrhage group (21 versus 14 days). No incidents of rebleeding were reported during the follow-up period (mean time of 15 ± 10.3 months).
Perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage are two different entities that have different clinical outcomes, namely in terms of complication rate and median inpatient time. The management of these patients should respect this difference to improve treatment and optimize health care resources.
比较脑周蛛网膜下腔出血和非脑周蛛网膜下腔出血的临床演变情况。
本研究在葡萄牙北部地区的一家三级医院中心进行回顾性研究。纳入的患者蛛网膜下腔出血病因不明。考虑到脑周蛛网膜下腔出血和非脑周蛛网膜下腔出血的差异，对若干流行病学、临床和影像学方面进行了统计分析。
62例患者符合纳入标准（46.8%为脑周蛛网膜下腔出血；53.2%为非脑周蛛网膜下腔出血）。两组的人口统计学和临床背景特征相似。非脑周蛛网膜下腔出血患者的并发症更为常见——84.8%的患者至少有一种并发症，而脑周蛛网膜下腔出血患者为48.3%。血管痉挛、感染和脑积水是最常见的并发症（在非脑周蛛网膜下腔出血组中每种并发症的检出频率均高于脑周蛛网膜下腔出血组）。两名患者死亡，均为非脑周蛛网膜下腔出血。非脑周蛛网膜下腔出血组的中位住院时间更长（分别为21天和14天）。随访期间（平均时间为15±10.3个月）未报告再出血事件。
脑周蛛网膜下腔出血和非脑周蛛网膜下腔出血是两种不同的疾病实体，具有不同的临床结局，即在并发症发生率和中位住院时间方面。对这些患者的管理应尊重这种差异，以改善治疗并优化医疗资源。
