Nghiên cứu mối quan hệ giữa các đặc điểm lâm sàng và biến chứng ở bệnh nhân xuất huyết màng não cấp

Subarachnoid hemorrhage (SAH) accounts for 10 percent of all stroke. This is a severe disease of the stroke. The main cause of SAH is ruptured cerebral arteries aneurysms, accounts for 80 percent. Patients have more serious complications such as rebleeding, hydrocephalus, electrolyte disorders and particularly cerebral vasospasm that cause cerebral infarction and it is the main cause leading to death or severe disability. Patients with subarachnoid hemorrhage should be diagnosed early, monitored carefully and managed complications timely to reduce the mortality and morbidity. Objective: Study the clinical characteristics, the relationship between the clinical characteristics and complications in patients with subarachnoid hemorrhage. Methods: Cross-sectional prospective study on 110 patients who suffered from SAH addmited to Stroke Center in No.108 Hospital, from December 2008 to December 2013. Results and conclusions: research results of clinical characteristics and complications during the acute phase of 110 patients with SAH, the authors found that: the ratio of male/female was 1.6/1; the mean age was 49.76 +/- 18.5; the major clinical symptoms: sudden, severe headache accounted for 89 percent; meningeal syndrome (86.4 percent); hemiplegia (16.4 percent); the clinical symptoms according to Hunt - Hess scale: from grade I to grade III accounted for 70 percent. The results of digital subtraction angiography (DSA): 59 percent of patients had the aneurysms belong to anterior communicating artery (27.7 percent), intracranial internal carotid artery (26 percent), middle cerebral artery (17 percent), anterior cerebral artery (6.2 percent), posterior communicating artery (7.7 percent) and basilar artery (15.4 percent). The common complications were cerebral vasospasm accounted for 30.9 percent, ventricular dilatation 17.3 percent. These complications related to the severity of SAH and the aneurysmal characteristics. Rebleeding accounted for 11.8 percent, presented in the first week. Hyponatremia accounted for 38.2 percent, occurred on day 5 - 14 (9.8 +/- 5.5), prolonged fever (31.8 percent). the authors found also the cardiac arrhythmias and a number of changes in cardiac conduction as prolonged QT, flat T wave accounted for 10.9 percent, 29.1 percent and 34.5 percent, respectively. There was an association between clinical severity (Hunt - Hess of IV - V), as well as the characteristics of the aneurysms (no intervention) to increase the risk of rebleeding and cerebral vasospasm following SAH.