Neurological outcome in patients of traumatic subarachnoid haemorrhage: A study of prognostic factors & role of MRI

Abstract

Objective

Our present study aims to investigate various prognostic factors associated with the neurological outcome among patients of post-traumatic SAH on the basis of clinical findings and CT scan evidence. We studied further to establish sequences of MRI as a diagnostic tool for detection of fresh tSAH and contusions.

Methods

A prospective study was conducted in which 117 patients were enrolled for study. Data of initial severity, GCS, CT & MRI scan (FLAIR/GRE) findings, Fisher grading, Marshall classification and GOS on discharge were collected. Amount of blood, anatomical sites of SAH, MRI changes were recorded. GOS on discharge and after one month was compared. Statistical analysis of data was done.

Results

tSAH was found more common in adolescent male in RTA. Most common anatomical site was sulcal spaces over convexity. Contusion was the most commonly associated pathology. Univariate analysis of data showed significant correlation of prognosis with GCS, Fisher grade, presence of SDH and fresh SAH on MRI scans. Death rate was maximum in Fisher grade III (6.06%) relating SAH thickness. On MRI sequence, 12 patients had evidence of fresh SAH and contusions.

Conclusions

The outcome of tSAH depends on the GCS at admission, amount and distribution of SAH. MRI is a good diagnostic tool.

Keywords

Traumatic SAH - Prognostic factors - Outcome - MRI in tSAH

Abbreviations

GCS, Glasgow coma scale - tSAH, Traumatic subarachnoid haemorrhage - GOS, Glasgow outcome scale - CI, confidence interval - RTA, road traffic accident

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