• B S Chan and N W Dorsch.
• Westmead Hospital, NSW.
• Med. J. Aust. 1991 Apr 15; 154 (8): 509-11.

ObjectiveTo determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in whom the diagnosis was delayed.DesignA two-year retrospective study of medical records of patients admitted to Westmead Hospital between July 1988 and June 1989.SettingA tertiary level teaching hospital.PatientsNinety-four patients treated for subarachnoid haemorrhage. In 15 cases the diagnosis was delayed.Main Outcome MeasuresDeath, disability, or functional recovery.ResultsOverall, 40 (42.5%) patients died, 14 (15%) were disabled, and 40 made a functional recovery. Of the 62 patients who were treated surgically 38 (61%) made a functional recovery compared with two of the 32 (6%) who were not. Of the 15 in whom the diagnosis was delayed seven (47%) made a functional recovery. Confirmation of the diagnosis was delayed in four of the latter group because a cranial computed tomography scan showed no abnormalities.ConclusionsEarlier diagnosis, allowing early definitive surgical treatment, may improve the outcome in aneurysmal subarachnoid haemorrhage. The results of a computed tomography scan are diagnostic only if they are positive--a negative result must be interpreted in conjunction with the clinical picture.

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