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ZDERKIEWICZ
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Tytuł oryginału:
Clinical signs pointing to the source of hemorrhage in multiple intracranial aneurysms.
Autorzy:
Zderkiewicz
Edward,
Pawlik
Zbigniew,
Czochra
Marian,
Tabora
Arkadiusz
Źródło:
Med. Sci. Monitor 2002: 8 (2) s.CR83-CR86, tab., bibliogr. 17 poz.
Sygnatura GBL:
313,278
Hasła klasyfikacyjne GBL:
pediatria
neurologia
Typ dokumentu:
praca kliniczna
tytuł obcojęzyczny
Wskaźnik treści:
ludzie
dzieci 6-12 r.ż.
dzieci 13-18 r.ż.
dorośli 19-44 r.ż.
dorośli 45-64 r.ż.
dorośli = 65 r.ż.
płeć męska
płeć żeńska
Streszczenie angielskie:
Background: In multiple aneurysms of cerebral vessels it is essential to correctly identify the aneurysm that has caused the hemorrhage, since it must be operated first. On the basis of our own material, we have evaluated the usefulness of various clinical signs and examinations in diagnosing which of several aneurysms was the cause of an intracranial hemorrhage. Material/Methods: The material consited of 163 patients with a total of 391 aneurysms. Diagnosis was based on panangiography and neurological examiantions in all cases and CT in the majority. Results.: All the diagnostic examiantions in question (neurological, angiography, CT and intraoperative evaluation) anabled a correct diagnosis in 72.6 p.c. of cases. In CT scanning, diagnostic value diministhes with time. Intracerebral hematoma is the most persistent sign. The highest rupture index a involved aneurysms localized on the anterior communicating artery, while those on the internal carotid artery ranked second. Four patients in whom intraoperative evaluation showed that the order in which the aneurysms wre treated srugically was erroeus died as the result of rebleeding that occurred prior to planned follow-up surgery. Conclusions: It is vitally important for outcome to determine which of several aneurysms has ruptured, since errors in the sequencing of surgical repair significantly increase mortality due to rebleeding preceding the next stage of surgery. When diagnosing the source of a hemorrhage one should take into account neurological findings, angiography, ECG, CT, MRI, and the location of the aneurysms.
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