Hemorragia subaracnoidea idiopática. Estudio clínico de una serie de 258 casos
P.A. Gómez, J.J. Rivas, R.D. Lobato, A. Cabrera, R. Alday, S. Castro, J.M. Ortega, H. Sandoval, E. Lamas
Servicio de Neurocirugía, Hospital «12 de Octubre», Madrid
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"apellidos" => "Alday" ] 5 => array:2 [ "nombre" => "S." "apellidos" => "Castro" ] 6 => array:2 [ "nombre" => "J.M." "apellidos" => "Ortega" ] 7 => array:2 [ "nombre" => "H." "apellidos" => "Sandoval" ] 8 => array:2 [ "nombre" => "E." "apellidos" => "Lamas" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía, Hospital «12 de Octubre», Madrid" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec162256" "palabras" => array:5 [ 0 => "Hemorragia subaracnoidea" 1 => "angiografia negativa" 2 => "hallazgos TC" 3 => "complicaciones" 4 => "evolución final" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec162257" "palabras" => array:5 [ 0 => "Subarachnoid hemorrhage" 1 => "negative angiography" 2 => "CT findings" 3 => "complications" 4 => "outcome" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analizan retrospectivamente 258 casos consecutivos de hemorragia subaracnoidea idiopática, tratados durante los años 1974–1991; éstos representan el 34% del total de hemorragias subaracnoideas diagnosticadas en el mismo período. Se discuten los datos clínicos y radiológicos de ésta en entidad y se comparan con los de la hemorrragia subaracnoidea aneurismática, comprobándose una menor incidencia de complicaciones neurológicas (isquemia 8% y resangrado 6%) y una mejor evolución final (90,3% independientes y sólo un 5,4% de mortalidad) que en los pacientes con aneurisma. Asimismo, se analiza la distribución de sangre en las cisternas subaracnoideas, apreciándose una mayor afectación de las cisternas peritruncales (interpeduncular y ambiens). Se desaconseja repetir el estudio angiográfico si éste es completo y de buena calidad, pudiéndose repetir éste si existe resangrado, si el grado clínico inicial es malo, si hubo vasoespasmo en el estudio angiográfico, o si la TC al ingreso muestra una extensa distribución de sangre por cisternas basales.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A series of 258 cases of subarachnoid hemorrhage of unknown etiology (SAHUE) is analyzed. These cases represent 34% of the total cases of primary subarachnoid hemorrhage diagnosed during the same period. The clinical and radiological findings in patients with SAHUE are compared with those in patients with ruptured aneurysm. The most important neurological complications i.e., ischemia and rebleeding had a lower incidence in patients with SAHUE (8% and 6% respectively) and the final outcome was more favourable than in patients with ruptured aneurysm (90,3% of the patients recovered and only 5,4% died). The analysis of the location of extravasated blood in patients with SAHUE showed a preferent distribution in the interpeduncular and ambiens cisterns, in contrast to patients with ruptured aneurysms. Concerning misdiagnosis resulting from an overlooked aneurysm at initial angiography, we suggest that cerebral angiography should be repeated when 1) the initial study shows vasospasm, 2) when rebleeding occurs, 3) if the initial clinical grade is bad and, 4) when the initial CT sean shows diffuse subarachnoid bleeding through the basal cisterns.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Gómez, P.A.; Rivas, J.J.; Lobato, R.D.; Cabrera, A.; Alday, R.; Castro, S.; Ortega, J.M.; Sandoval, H.; Lamas, E.: Hemorragia subaracnoidea idiopática. Estudio clínico de una serie de 258 casos. Neurocirugía 1992; 3: 197–205.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:57 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 4 | 1 | 5 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 18 | 22 | 40 |
| 2018 Enero | 16 | 21 | 37 |
| 2017 Diciembre | 13 | 28 | 41 |
| 2017 Noviembre | 54 | 53 | 107 |
| 2017 Octubre | 13 | 25 | 38 |
| 2017 Septiembre | 17 | 35 | 52 |
| 2017 Agosto | 17 | 37 | 54 |
| 2017 Julio | 14 | 34 | 48 |
| 2017 Junio | 19 | 55 | 74 |
| 2017 Mayo | 31 | 43 | 74 |
| 2017 Abril | 19 | 40 | 59 |
| 2017 Marzo | 9 | 45 | 54 |
| 2017 Febrero | 4 | 38 | 42 |
| 2017 Enero | 29 | 21 | 50 |
| 2016 Diciembre | 38 | 26 | 64 |
| 2016 Noviembre | 32 | 25 | 57 |
| 2016 Octubre | 40 | 40 | 80 |
| 2016 Septiembre | 44 | 34 | 78 |
| 2016 Agosto | 64 | 31 | 95 |
| 2016 Julio | 41 | 44 | 85 |
| 2016 Junio | 1 | 0 | 1 |
| 2016 Febrero | 3 | 0 | 3 |
| 2015 Diciembre | 3 | 0 | 3 |
| 2015 Julio | 3 | 7 | 10 |
| 2015 Junio | 10 | 18 | 28 |
| 2015 Mayo | 20 | 17 | 37 |
| 2015 Abril | 13 | 24 | 37 |
| 2015 Marzo | 17 | 24 | 41 |
| 2015 Febrero | 21 | 16 | 37 |
| 2015 Enero | 16 | 19 | 35 |
| 2014 Diciembre | 14 | 23 | 37 |
| 2014 Noviembre | 29 | 22 | 51 |
| 2014 Octubre | 17 | 31 | 48 |
| 2014 Septiembre | 12 | 18 | 30 |
| 2014 Agosto | 18 | 25 | 43 |
| 2014 Julio | 20 | 24 | 44 |
| 2014 Junio | 14 | 29 | 43 |
| 2014 Mayo | 26 | 27 | 53 |
| 2014 Abril | 19 | 25 | 44 |
| 2014 Marzo | 14 | 28 | 42 |
| 2014 Febrero | 13 | 23 | 36 |
| 2014 Enero | 10 | 21 | 31 |
| 2013 Diciembre | 12 | 20 | 32 |
| 2013 Noviembre | 15 | 25 | 40 |
| 2013 Octubre | 17 | 14 | 31 |
| 2013 Septiembre | 20 | 18 | 38 |
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| 2013 Marzo | 11 | 30 | 41 |
| 2013 Febrero | 14 | 20 | 34 |
| 2013 Enero | 18 | 17 | 35 |
| 2012 Diciembre | 8 | 19 | 27 |
| 2012 Noviembre | 0 | 24 | 24 |
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