Cefalea centinela en hemorragia subaracnoidea en el Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón período 2014-2015
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
La Hemorragia Subaracnoidea constituye un desafío diagnóstico e implica intervenciones complejas, sofisticadas, multidisciplinarias y raramente rutinarias. La sospecha clínica de esta enfermedad radica en la aparición de cefalea súbita severa con pico en minutos y que persiste más de una hora llamada cefalea centinela. El propósito de esta investigación fue determinar la frecuencia de cefalea centinela como posible signo de alerta de Hemorragia subaracnoidea en pacientes del Hospital de Especialidades Dr. Abel Gilbert Pontón durante el periodo 2014-2015,. El presente estudio fue de tipo observacional, analítico, retrospectivo de corte transversal. Se analizó todas las historias clínicas de los pacientes atendidos en el Servicio de Neurología desde el 1 de enero del 2014 hasta el 31 de diciembre del 2015. Durante el periodo 2014 y 2015, se reportaron 317 pacientes con diagnóstico de hemorragia subaracnoidea según el cóigo CIE-10, de los cuales se observó que la mayoría se presentaron en el año 2014 (189 casos), especialmente en el mes de diciembre. La manifestación clínica principal fue la cefalea súbita tambien llamada cefalea centinela, se presento en una proporción del 65,93% (209 casos) del total de pacientes analizados. La etiología principal del total de pacientes analizados en el 88,01% (279) fue el aneurisma cerebral y la complicación más frecuente fue la hemorragia cerebral (34%). La cefalea centinela esuvo presente en el 86,89% (53), del total de pacientes que desarrollaron complicaciones clínicas. Se encontró asociación estadísticamente significativa entre la presencia de cefalea centinela y la evolución clínica (p <0,05).
Subarachnoid hemorrhage is a diagnostic challenge and involves complex, sophisticated, multidisciplinary and rarely routine interventions. The clinical suspicion of this disease is the appearance of sudden severe headache with peak minutes that persists over an hour called sentinel headache. The purpose of this research was to determine the frequency of sentinel headache as a possible warning sign of subarachnoid hemorrhage in patients Specialty Hospital Dr. Abel Gilbert Ponton during the period 2014-2015 ,. This study was observational, analytical, cross-sectional retrospective. all medical records of patients treated at the Neurology from 1 January 2014 until 31 December 2015. During the period 2014 and 2015 were analyzed, 317 patients were reported with a diagnosis of subarachnoid hemorrhage according to cóigo CIE -10, of which it was noted that most occurred in 2014 (189 cases), especially in the month of December. The main clinical manifestation was also called sentinel headache sudden headache, it was presented at a rate of 65.93% (209 cases) of all patients analyzed. The main etiology of all patients analyzed in 88.01% (279) was the cerebral aneurysm and the most frequent complication was cerebral hemorrhage (34%). The sentinel headache esuvo present in 86.89% (53) of all patients who developed clinical complications. statistically significant association between the presence of sentinel headache and clinical outcome (p <0.05) was found.
Subarachnoid hemorrhage is a diagnostic challenge and involves complex, sophisticated, multidisciplinary and rarely routine interventions. The clinical suspicion of this disease is the appearance of sudden severe headache with peak minutes that persists over an hour called sentinel headache. The purpose of this research was to determine the frequency of sentinel headache as a possible warning sign of subarachnoid hemorrhage in patients Specialty Hospital Dr. Abel Gilbert Ponton during the period 2014-2015 ,. This study was observational, analytical, cross-sectional retrospective. all medical records of patients treated at the Neurology from 1 January 2014 until 31 December 2015. During the period 2014 and 2015 were analyzed, 317 patients were reported with a diagnosis of subarachnoid hemorrhage according to cóigo CIE -10, of which it was noted that most occurred in 2014 (189 cases), especially in the month of December. The main clinical manifestation was also called sentinel headache sudden headache, it was presented at a rate of 65.93% (209 cases) of all patients analyzed. The main etiology of all patients analyzed in 88.01% (279) was the cerebral aneurysm and the most frequent complication was cerebral hemorrhage (34%). The sentinel headache esuvo present in 86.89% (53) of all patients who developed clinical complications. statistically significant association between the presence of sentinel headache and clinical outcome (p <0.05) was found.
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Cefalea, Hemorragia subaracnoidea, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador