ผลการรักษาโรคหลอดเลือดสมองโป่งพองโดยวิธีผ่าตัดในโรงพยาบาลราชบุรี

บทคัดย่อ

          Aneurysmal subarachnoid hemorrhage remain a significant challenge to neurological surgeon. A retrospective study for the result of surgical management of ruptured aneurysm in Ratchaburi hospital were studied from July 1, 1999 to April 30, 2005. 68 patients (46%) suffered from aneurysmal subarachnoid hemorrhage. The number of patients might be less than expected from the limitation of aneurysm detection by the X-ray machine in this hospital. Severity classification of subarachnoid hemorrhage by World Federation of Neurological Surgeons scale has been used in this study. The results were 32% in grade 1, 9% in grade 2, 4% in grade 3, 38% in grade 4 and 20% in grade 5. Glasgow Outcome Scale was used to measure functional outcome : good recovery 38%, moderate disability 12%, severe disability 9%, persistent vegetative state 3% and dead 38%. Level of consciousness was found to be the most important factor to determine surgical outcome in Ratchaburi hospital. Mortality difference between grade 4,5 and grade 1,2,3 was statistically significant.