By R Loch Macdonald; Bryce Weir
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Extra resources for Cerebral vasospasm
Vasospasm as a cause of death and disability has decreased from approximately 35% in the 1970s, to 20% in the 1980s, to 10% currently. --Neil Kassell, Fifth International Conference on Cerebral Vasospasm, 1993. In one of the large cooperative studies reported in 1993, there were 457 patients in a placebo group composed of all neurological grades. Fifty-one percent had angiographic VSP, 46% developed DID, and 18% died. Four percent of deaths were attributed solely to VSP and 10% to multiple causes including VSP.
Only 15% of their 443 patients developed postoperative VSP. VSP lasted 8-24 days, with a mean duration of 14 days. Of patients with VSP, 46% recovered and were working. Thirty patients had operations carried out while VSP was present. 4 days following SAH, and 80% were well and working. Operative mortality and VIII. INFLUENCE OF SURGERY morbidity were closely related to the admission grade of the patient. 6 days from SAH. The range of onset was 4-16 days for both groups. Of 68 patients with preoperative VSP, 52% did well, 24% had a fair result, and 25% died.
And Yamaura, A. (1996). Clinical grading and outcome after early surgery in aneurysmal subarachnoid hemorrhage. Neurosurgery 39, 441-447. 4 Preoperative Fisher Computed Tomography Classification of Subarachnoid Hemorrhage and Glasgow Coma Scale (GCS) a GCS score D. , and Yamaura, A. (1996). Clinical grading and outcome after early surgery in aneurysmal subarachnoid hemorrhage. Neurosurgery 39, 441-447. b Most common Fisher grade for this GCS. patients developed VSP, 15% showing ischemic symptoms only and 19% showing CT infarction.