원인불명의 뇌지주막하 출혈의 장기추적 관찰
Subarachnoid Hemorrhage of Unknown Etiology : Long-term Follow-up
소속 상세정보
이정만/Jeong Man Lee
김국기/박종태/임영진/김태성/이봉암/임언/Gook Ki Kim/Jong Tea Park/Young Jin Lim/Tae Sung Kim/Bong Arm Rhee/Won Leem.
KMID : 0359819980270121687
Abstract
결론
본 교실에서는 1985년 1월부터 1995년 12월까지 11년간 원인불명의 뇌지주막하 출혈 환자
28례를 대상으로 장기 추적관찰하여 예후 및 임상 분석을 통해 다음과 같은 결론을 얻었다.
원인불명의 뇌지주막하 출혈 환자의 임상경과 및 예후는 뇌동맥류의 파열에 의한 뇌지주막
하 출혈 환자에서 보다 좋았으며, 입원당시 임상상태가 경미할수록, 뇌전산화 단층촬영 소견
상 출혈양이 적을수록 좋은 예후를 보였다 동맥류의 파열에 의한 뇌지주막하 출혈보다 원인
불명의 뇌지주막하 출혈에서 고혈압을 동반하는 경우가 많았으며 원인불명의 뇌지주막하 출
혈 환자중에서 고혈압을 동반한 경우에는 동반하지 않은 경우보다 합병율이 높았다. 치료로
서는 보존적 치료만으로 충분하며 , 대부분의 환자는 어떠한 제한없이 일상 생활을 영위하
였다.
#초록#
Twenty eight patients with negative but technically satisfactory four-vessel
angiography-admitted to our department from 1985 to 1995 were followed for long term
evaluation. The of this retrospective study of patients with SAH of unknown etiology
was to evaluate the clinical features, long-term prognosis in mortality rate and risk of
rebleeding. and the daily functional capacity. Twenty eight out of 1035(2.7%)
spontaneous subarachnoid hemorrhage patients were found to have subarachnoid
hemorrhage(SAH) of unknown etiology. Twenty eight patients were confirmed as SAH,
by computed tomography or lumbar puncture. CT scan was undertaken in all cases(in
28 cases within 5 days of hemorrhage). SAH of unknown etiology classified as Hunt
and Hess grade I was 60. 7% of cases, but there no patients with Grade V. Arterial
hypertension was present on admission in 35.7% of cases. We only performed the
angiogram once in 16 of 28 patients, but there were no rebleedings caused by aneurysm.
The period of follow-up ranged from 2 to 11 years, with the mean of 4.3 years. Only
one of 28 patients(3.6%) experienced late rebleeding, and again had normal cerebral
panangiography. Two patients(7.1%) showed a moderate disability in activities of daily
living. one patient(3.6%) was mild disabled, and two(7.1%) had died of pneumonia. Based
on the ADL grade Grade I was 28.6% at the time of discharge however, during
follow-up, increased up to 81.5%.
키워드
Subarachnoid hemorrhage; Unknown etiology; Prognosis.;
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