Prognostic value of the amount of post-traumatic subarachnoid haemorrhage in a six month follow up period

Abstract

Clinical and radiological patterns from 148 patients with post-traumatic subarachnoid haemorrhage (TSAH) were analysed with specific regard for the amount and distribution of blood in subarachnoid spaces to verify if these variables have any influence on overall outcome. The degree and extent of TSAH were classified according to Fisher's criteria: in 93 patients it was grade 1, in 36 grade 2, in 13 grade 3, and in six grade 4. There was a significant correlation between increasing clinical severity at admission and the amount of subarachnoid bleeding and a direct relation between a favourable outcome and a low Fisher grade. The distribution of subarachnoid blood was not significantly related to clinical condition at admission, whereas the pattern had a significant impact on the outcome. The results of the present study confirm that TSAH is a negative prognostic factor. Whereas the degree of TSAH is mainly related to clinical conditions at admission, the presence of subarachnoid blood clots both in basal cisterns and over the cerebral convexity indicates a poor outcome.