Labauge R, Pagès M, Roelens P, Blard J M, Issautier F, Campello C
Clinique Neurologique, Centre Médico-Chirurgical Gui de Chaulia, Montpellier.
Rev Neurol (Paris). 1988;144(12):796-804.
In a 6-year-period, 234 cases of subarachnoid haemorrhage were observed in a neurological intensive care unit: 74 were male and 69 were female, aged from 15 to 94 years. In 15 cases no other investigation than C.T. scan or lumbar puncture was performed. In 143 patients, cerebral angiography demonstrated a ruptured aneurysm of cerebral vessels and 99 were operated. The prognosis was poor in old age, with aneurysms located on the anterior part of the circle of Willis, severe neurological involvement and extensive subarachnoid or ventricular haemorrhage. A recurrence of the haemorrhage occurred in 18 cases and cerebral ischaemia was present in 69 patients. The mortality rate of patients with ruptured aneurysms was 47.5 p. 100 (30.4 p. 100 when operated). Seventeen patients probably had a ruptured cerebral aneurysm but cerebral angiography was not conclusive; 12 of them died. In 15 other cases, the haemorrhage was related to cerebral angiomas (3 cases), endocarditis (2), coagulation disorders (6), cranial trauma (3) and Moya-Moya disease (1). In 44 patients, the aetiology of subarachnoid haemorrhage was unknown and the mortality rate was 14 p. 100. The poor prognosis of subarachnoid haemorrhage, worse than in neurosurgical series, is emphasized. It may be explained by the lack of selection of the patients in a non-surgical department.
在6年期间，神经重症监护病房观察到234例蛛网膜下腔出血病例：男性74例，女性69例，年龄在15至94岁之间。15例患者除了进行CT扫描或腰椎穿刺外未进行其他检查。143例患者经脑血管造影显示脑血管动脉瘤破裂，其中99例接受了手术。老年患者、位于 Willis 环前部的动脉瘤、严重神经功能受累以及广泛的蛛网膜下腔或脑室出血患者的预后较差。18例患者出现出血复发，69例患者存在脑缺血。动脉瘤破裂患者的死亡率为47.5‰（手术患者为30.4‰）。17例患者可能患有脑动脉瘤破裂，但脑血管造影结果不明确；其中12例死亡。在其他15例病例中，出血与脑血管瘤（3例）、心内膜炎（2例）、凝血障碍（6例）、颅脑外伤（3例）和烟雾病（1例）有关。44例患者蛛网膜下腔出血的病因不明，死亡率为14‰。强调了蛛网膜下腔出血的预后较差，比神经外科系列报道的情况更糟。这可能是由于在非手术科室未对患者进行筛选所致。
