Transcranial dopplerosonography in subarachnoid hemorrhagen
- VernacularTitle:Тархины торлог доорх цус харвалтын үеийн допплерoсонографийн шинжилгээний үзүүлэлт
- Author:
Altantsetseg P
1
;
Bilegtsaikhan Ts
2
;
Tovuudorj A
3
Author Information
1. The Third State Central Hospital
2. Mongolian National University of Medical Sciences, School of Biomedical Sciences
3. Mongolian National University of Medical Sciences, School of Medicine
- Publication Type:Journal Article
- Keywords:
aSAH;
Hunt-Hess scale;
Lindegaard index
- From:Mongolian Medical Sciences
2020;191(1):8-12
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:The incidence of acute SAH has been estimated at 2–22 cases per 100 000 persons per year. The
most common cause of basal acute SAH is a ruptured cerebral aneurysm. Cerebral vasospasm in
the first 2 weeks after aneurysmal subarachnoid hemorrhage is recognized as a major predictor of
delayed cerebral ischemia. From 2014 through 2018, 5272 patients with a stroke (amongst them
20.4% were patients with aSAH) were hospitalized in the 3rd State Central Hospital of Mongolia.
Objective:To study the clinical features of the cerebral vasospasm and dopplerosonography parameters in the
aSAH patients.
Materials and Methods:The methods, methodology and ethics of the research work were discussed at a Research meeting
of Ethics Control Committee of the Mongolian National University of Medical Sciences held on
December 22, 2017 (No2017 / 3-05), and the study was performed in accord with approval.
60 patients with aSAH (hospitalized from 2017 to 2018 year) were enrolled in the case-control
study. Informed consent were obtained from each participants. Clinical condition of participants was
classified by Hunt-Hess scale (HHS). Cerebral vasospasm degree was graded by Lindegaard index.
Results:52.5% of the participants were men and 47.5% were women. Average age was 49.9±12. When clinical
condition degree was compared to vasospasm grade it was revealed that amongst 1st degree of
Hunt-Hess scale (HHS) group 11.1% of enrolled patients’ spasm was normal or had no spasm, while
it was observed either 44.4% mild and moderate spasm. In the 2nd degree of HHS group: normal in
6.9%, mild in 3.4%, moderate in 86.2%, and severe spasm was in 3.4%. In the 3rd degree of HHS
group, 11.1% had no spasm, moderate spasm was in 77.8%, and severe spasm was in 11.1%. In 4th
degree of HHS group, 71.4% were with moderate spasm, 28.6% were with severe spasm (p = 0.001).
When the Hunt-Hess Scale was compared to the Sinus Rectus 1st degree of Hunt-Hess scale (HHS)
group Sinus Rectus was normal for 22.2% patients, mild for 66.7% and severe for 11.1%. Though 4th
and 5th degree of Hunt-Hess scale (HHS) groups’ Sinus Rectus mild for 7.1% normal, 50.0% mild
and 42.9% severe (p=0.007). Thus whenever the clinical condition worsened the cerebral intracranial
pressure was increasing.
Conclusion:aSAH patients clinical complication degree were directly associated with the cerebral vasospasm
revealed by the transcranial dopplerosonography. Therefore, the evaluation of Hunt-Hess scale has
an important significance in the prevention from clinical complications and in the selection of the
appropriate treatment approaches for aSAH patients.
- Full text:2020-191(1)-8-12.pdf
