Does aneurysm side influence the infarction side and patients´ outcome after subarachnoid hemorrhage?


Autoři: Nina Brawanski aff001;  Sepide Kashefiolasl aff001;  Sae-Yeon Won aff001;  Stephanie Tritt aff002;  Joachim Berkefeld aff002;  Christian Senft aff001;  Volker Seifert aff001;  Jürgen Konczalla aff001
Působiště autorů: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany aff001;  Institute of Neuroradiology, Goethe- University Hospital, Frankfurt am Main, Germany aff002;  Institute of Neuroradiology, Helios HSK Wiesbaden, Wiesbaden, Germany aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224013

Souhrn

Background

The prognostic factors and outcome of aneurysms appear to be dependent on its locations. Therefore, we compared left- and right- sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in terms of differences in outcome and prognostic factors.

Methods

Patients with SAH were entered into a prospectively collected database. A total of 509 patients with aneurysmal subarachnoid hemorrhage were retrospectively selected and stratified in two groups depending on side of ruptured aneurysm (right n = 284 vs. left n = 225). Midline aneurysms of the basilar and anterior communicating arteries were excluded from the analysis. Outcomes were assessed using the modified Rankin Scale (mRS; favorable (mRS 0–2) vs. unfavorable (mRS 3–6)) six months after SAH.

Results

We did not identify any differences in outcome depending on left- and right-sided ruptured aneurysms. In both groups, the significant negative predictive factors included clinical admission status (WFNS IV+V), Fisher 3- bleeding pattern in CT, the occurrence of delayed cerebral ischemia (DCI), early hydrocephalus and later shunt-dependence. The side of the ruptured aneurysm does not seem to influence patients´ outcome. Interestingly, the aneurysm side predicts the side of infarction, with a significant influence on patients´ outcome in case of left-sided infarctions. In addition, the in multivariate analysis side of aneurysm was an independent predictor for the side of cerebral infarctions.

Conclusion

The side of the ruptured aneurysms (right or left) did not influence patients’ outcome. However, the aneurysm-side predicts the side of delayed infarctions and outcome appear to be worse in patients with left-sided infarctions.

Klíčová slova:

Aneurysms – Hydrocephalus – Infarction – Left hemisphere – Lesions – Prognosis


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 11