Longstreth W T, Nelson L M, Koepsell T D, van Belle G
Department of Medicine, School of Medicine, University of Washington, Seattle.
Neurology. 1993 Apr;43(4):712-8. doi: 10.1212/wnl.43.4.712.
Over 2 years, we identified 171 patients in King County, Washington, experiencing an incident subarachnoid hemorrhage and characterized their clinical course and outcome. Most (65%) were women and most (68%) were under age sixty-five. Only five died without medical attention. The remaining 166 patients were hospitalized and had CTs of the head. Of these, 103 underwent aneurysm surgery, 40 developed acute hydrocephalus, 32 had symptomatic vasospasm, and 30 re-bled. Sixty-eight percent (68%) survived to 1 month after the bleed and 62% to 1 year. Independent predictors of good recovery by 1 month after the bleed included youth, a high score on the admission Glasgow Coma Scale, and absence of blood on the first CT. In this population-based series, at 1 month after the bleed, approximately one-third of patients were dead, one-third had neurologic deficits, and one-third were doing well.
在两年时间里，我们在华盛顿州金县识别出171例发生蛛网膜下腔出血的患者，并对他们的临床病程和转归进行了描述。大多数（65%）为女性，大多数（68%）年龄在65岁以下。只有5例未经治疗死亡。其余166例患者住院并接受了头部CT检查。其中，103例接受了动脉瘤手术，40例发生急性脑积水，32例出现症状性血管痉挛，30例再次出血。68%的患者在出血后1个月存活，62%在1年后存活。出血后1个月良好恢复的独立预测因素包括年轻、入院时格拉斯哥昏迷量表高分以及首次CT检查未见出血。在这个基于人群的系列研究中，出血后1个月时，约三分之一的患者死亡，三分之一有神经功能缺损，三分之一情况良好。
