Abstract
Objectives : To correlate preoperative Glasgow coma scale with early outcome of surgery. Methods: This prospective study was done at the department of neurosurgery of Dhaka Medical College (from January 2009 to June 2010) on consecutively selected patients with a suspicion of intracerebral haemorrhage and subsequently confirmed by CT scan of brain. A total of 30 hypertensive patients with their age ranged from 41 to 80 years with Glasgow coma scale 6 to 12 were included in this study. Co-morbid patients like cardiac, respiratory and renal failure requiring artificial maintenance of blood pressure and respiration were excluded in this study. All these patients were evaluated on the basis of detailed history from attendants (as patients were stuporous and semicomatose), clinical examination and subsequently CT scan of brain (at presentation and at 7th postoperative day). All these patients were operated and followed up during hospital stay and at 30-day after operation, by observing Glasgow coma scale and Glasgow outcome scale. Results: 20 patients had Glasgow coma scale 6 to 8 on admission, among them Glasgow outcome scale was 5 in 4(20.0%) patients, was 3 in 4(20.0%) patients and was 1 in 12(60.0%) patients. 10 patients had Glasgow coma scale 9 to 12 on admission, among them Glasgow outcome scale was 5 in 6 (60.0%) patients, was 4 in 1(10.0%) patient and was 3 in 3(30.0%) patients. Conclusion : Surgery in relation to preoperative Glasgow coma scale (Glasgow coma scale) had a significant correlation with early outcome of surgery. From the current study removal of haematoma when Glasgow coma scale >8 lower the morbidity and mortality, which was statistically significant DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8633 BSMMU J 2011; 4(2):70-75
Highlights
Spontaneous intracerebral haemorrhage is responsible for 10 to 15% of the acute stroke[1]
Mean (±SD) age of the patients were 55.70 ±10.25, peak age incidence of intracerebral haemorrhage was found in 41 to 50 years age group. 18(60%) patients had the history of irregular antihypertensive medication, 10(33.3%) patients had the history of regular medication and 2(6.7%) patients had no history of medication
Table-III Distribution of patients with intracerebral haemorrhage according to Glasgow coma scale (n=30)
Summary
Spontaneous intracerebral haemorrhage is responsible for 10 to 15% of the acute stroke[1]. Stroke is the leading cause of hospitalization in the U.S.A. Combining of all types of stroke it is the 3rd leading cause of death in adult population i.e over 40 years of age after ischemic heart disease and cancer in developed country and the first leading cause of disability[2]. According to WHO, stroke may be defined as rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin[3]. There are two main types of stroke: Ischemic stroke 85% and haemorrhagic stroke 15%. Haemorragic stroke accounts for only 10 to 15% of first ever stroke, with a 30-day morality rate of 35% to 52%; half of deaths occur in the first 2 days[4]
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