بررسی 26 مورد خونریزی ساب آراکنویید منجر به فو ت، متعاقب پارگی آنوریسم عروق مغزی ارجاعی به پزشکی قانونی تهران - سال 1384

Abstract Background & Aim: Nontraumatic subarachnoid hemorrhage is a neurologic emergency, which has a high rate of death and complications and its risk factors are preventable to some extent. Aim of this study is to investigate: risk factors, epidemiology, manifestations of disease and distinction between NSH and traumatic subarachniod hemorrhage. Materials & Methods: This study is a descriptive research based on 26 persons died due to aneurismal subarachniod hemorrhage in 2005-2006 send to Legal Medicine Organization of Tehran. Variables such as age, sex, duration from initiation of disease until death, manifestation of disease, type, location, amount and source of bleeding and also risk factors which are all investigated with autopsy and interview will relatives and studying clinical reports. Results: Among 26 persons died due to aneurismal subarachnoid hemorrhage, 69% were male, 31% were female , and mean age was at 47 years. The most common symptoms on the onset of disease were sudden onset of severe headache and loss of consciousness. 73% of them died within 24 hours after the event. 62% had a history of hypertention, 42% did cigarette smoking, 35% were exposed to sever excitations, 19% had a history of headache. In all cases, there was subarachnoid hemorrhage, 31% with intraventricular bleeding, 8% with intra cerebral hemorrhage. Although in 25% of cases determining the position of rupture was impossible as a result of bleeding severity, clot around vessels and brain death a few day before autopsy, in 40% of cases bleeding had happened in anterior part and in 35% of cases in posterior part of Williss cycle. Conclusion: It seems that serious intervention for reducing risk factors such as cigarette smoking, hypertention and sever excitation can reduce risk of rupture of an intracranial aneurysm. Rate of death within 24 hours of the onset of disease was extremely more than other countries. More researches should be done about transporting duration of patients to medical centers, determining the amount of primary bleeding, rebleeding, vasospasm and efficiency of treatment.