Abstract

MIRANDA HERNANDEZ, José Luis et al. Care of patients with "good grades" of aneurysmal subarachnoid hemorrhage in the stroke unit. Rev cubana med [online]. 2014, vol.53, n.3, pp.239-253. ISSN 0034-7523.

Objective: estimate the impact of care to patients with "good grades"of aneurysmal subarachnoid hemorrhage (ASH-A) . Methods: a prospective descriptive study was conducted of a cohort of patients with "good grades" of ASH-A admitted to the Stroke Unit at Hermanos Ameijeiras Hospital in Havana from October 2005 to December 2009. Data was processed with the statistical software SPSS version 15.0. Results: 165 patients were studied. Mean age was 49.7 and female sex predominated (66.7 %). The cerebral aneurysm could be isolated in 141 cases: 131 by surgery and 10 by endovascular procedure. In 21 cases treatment was performed before the third day of evolution. The main complications observed were rebleeding (18.8 %), symptomatic vasospasm (15.2 %), hydrocephaly (23 %), hyponatremia (11.5 %) and pneumonia (10.3 %). Average hospital stay was 17.1 days. 20 patients were discharged with disabling sequelae; 27 died. The variables associated with a bad outcome at discharge were intensity of clinical manifestations at admission, magnitude of bleeding on CT brain scans, rebleeding, symptomatic vasospasm and pneumonia. Conclusions: stroke Unit specialized care seems to be appropriate for patients with "good grades" of ASH-A.

Keywords : cerebral aneurysms; cerebral hemorrhage; subarachnoid hemorrhage; stroke; stroke unit.

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