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《Chinese Journal of Neuromedicine》 2007-07
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Chance for DSA and therapeutic strategies for spontaneous subarachnoid hemorrhage

SHU Hang CHEN Guang-zhong LI Zhao-jie ZENG Shao-jian.Department of Neurosurgery,Guangdong Provincial People's Hospital,Guangzhou 510080,China  
Objective To investigate the optimal chance for digital subtraction angiography (DSA)and therapeutic strategies for spontaneous subarachnoid hemorrhage(SAH).Methods The clinical data of 1015 patients with spontaneous SAH,who were admitted to our hospital between January,2000 and January,2007 and underwent DSA were retrospectively analyzed to summarize the optimal chance for DSA,primary etiological factors of hemorrhage,therapeutic strategies and prognostic status.Results A total 50 cases underwent DSA within 24 h after SAH,429 cases between 1-3d,396 cases between 3-7d,77 cases between 7d and 2 weeks,and 63 cases between 2 weeks and 1 month. Among the 1015 cases,there were 768 cases with aneurysms,12 cases with cerebral arteriovenous malformations,15 cases with venous malformations,50 cases with spontaneous perimesencephalic hemorrhage,11 cases with dural arteriovenous fistulae,4 cases with MoyaMoya and 155 cases with unknown causes.Among the 768 cases with aneurysms,692 cases underwent endovascular embolism,67 cases underwent surgical clipping,5 cases underwent pathogenesis-discarded therapy due to multiple aneurysms,and 4 cases died of preoperative re-hemorrhage.Among the patients with aneurismal SAH, 730 cases got GOS score 5;13 cases,4;10 cases,3;1 case,2;and 14 cases,1.Patients with non-aneurismal SAH all got GOS score 5.Among the 38 cases with GOS score below 4,30 cases underwent their first DSA 7d later after hospitalization.Conclusion It is of great importance for the patients with non-life-threatening SAH to accept DSA detection to find their etiological factors and for doctors to select fight therapeutic strategies necessary for a good prognosis.
【Fund】: 广东省科技计划项目(2005B33801007)
【CateGory Index】: R743.35
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