Grados altos en la Escala de Fisher predicen el desarrollo de hidrocefalia en pacientes con hemorragia subaracnoidea espontanea
Objetive. To determine if high grades of Fisher scale are useful to predict the development of hydrocephalus in consecutive Colombian patients with spontaneous subarachnoid hemorrhage (SAH) assessed from January 2005 to April 2012 with 12 month follow-up. Methods. 251 patients were included in a r...
|Formato:||Trabajo de grado (Bachelor Thesis)|
Universidad del Rosario
Hemorragia subaracnoidea espontánea, escala de Fisher, tomografía axial computarizada, Hunt-Hess, hidrocefalia aguda, subaguda y crónica; punción lumbar seriada, ventriculostomía, derivación ventriculoperitoneal, fenestración de lámina terminalis, revisión sistemática de la literatura.
Subarachnoid hemorrhage, Fisher Scale, CT Scan, Hunt-Hess, acute, subacute and chronic hydrocephalus, lumbar puncture, ventriculostomy, ventriculoperitoneal shunt, lamina terminalis fenestration, systematic review of literature.
|Acceso en línea:||http://repository.urosario.edu.co/handle/10336/4515|
|Sumario:||Objetive. To determine if high grades of Fisher scale are useful to predict the development of hydrocephalus in consecutive Colombian patients with spontaneous subarachnoid hemorrhage (SAH) assessed from January 2005 to April 2012 with 12 month follow-up.
Methods. 251 patients were included in a restrospective manner. The association between Fisher scale and hydrocephalus was analyzed bivariate and multivariate analysis. In addition, a systematic literature review (SLR) was done.
Results. In our cohort of patients, the etiology of SAH was due to aneurysms; 78,5%. The prevalence of hydrocephalus was found to be of 27,1%. Overall survival with a 12 month follow-up was of 65,7%. Average age of included patients was 55,5 ± 15 years, and most of them were women; 65,7%.
Having Fisher 4 and Hunt-Hess III are significantly associated with hydrocephalus: adjusted OR: 2.93 95% CI: 1.51-5.65, P <0.001, adjusted OR: 2.83 95% CI: 1.31-6.17 P=0.008 respectively. The SRL showed an overall prevalence of hydrocephalus between 17 and 68% and mortality varied between 3.0% and 33%. 50% of the included studies significantly associated intraventricular hemorrhage ( Fisher 4) with hydrocephalus.
Conclusion. Our results confirm current concepts on post-SAH hydrocephalus and the fact that is obstructive and secondary to Fisher 4 and having neurological impairment on admission (Hunt and Hess III).|