Organic psychosis refers to a group of diseases currently classified as “mental disorders due to a medical illness”, unlike the absence of specific organic causality that exists in primary disorders. These are secondary to long-term processes , which is necessary to re-evaluate frequently due to the association between age-related deterioration, comorbidity and the evolution of psychosis itself. We present the case of a patient with subarachnoid hemorrhage secondary to a ruptured arteriovenous malformation, who suffered from a slight change in behavior and decreased cognitive functions with subsequent evolution to dissociative symptoms, episodes of hypersomnia and disconnection from the environment, through assessment joint of specialties was reached the diagnosis of organic psychosis type schizophreniform disorder.
Subarachnoid Hemorrhage
Validación de Diferentes Escalas en la Evaluación del Pronóstico de Pacientes con Hemorragia Subaracnoidea Espontánea en el Hospital Regional “Dr. Teodoro Maldonado Carbo” entre Mayo-2011 y Mayo-2014
Background: Subarachnoid Hemorrhage (SAH) is associated with a high mortality rate and functional consequences. Several scales have been created in order to assess prognosis after SAH, and even though they have been widely studied, neither has achieved universal acceptance.
Objective: Validate different scales assessing the prognosis of patients with spontaneous SAH in a local hospital population.
Methods: A retrospective, cross-sectional study was conducted on patients admitted to the “Dr. Teodoro Maldonado Carbo” Hospital, diagnosed with spontaneous SAH, between 18 and 75 years. Descriptive statistics and Spearman correlation coefficient were calculated in order to evaluate the association of the Hunt and Hess, WFNS and Fisher Scales with functional outcome.
Results: Hunt and Hess Scale had a higher correlation (60,3%; p=0,000) with the functional outcome at discharge or death, compared to 55,3% (p=0,000) obtained by the World Federation of Neurological Surgeons Scale and 50% (p=0,000) by Fisher Scale. In addition, the Glasgow Coma Scale score (-58,4%; p=0,000), altered pupillary response (54,7%; p=0,000) and the need for invasive mechanical ventilation (73,8%; p=0,000) were factors associated with functional score.
Conclusion: Hunt and Hess Scale revealed a good correlation with the Rankin functional scale at discharge or death, and is superior to the other scales in evaluating the prognosis of patients with spontaneous subarachnoid hemorrhage.
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Aneurismas intracraneales múltiples Presentación de un caso y revisión de la literatura.
Prior to review of literature, we present the case of a 51 year old woman, with arterial hypertension, who presented with a hemorrhagic stroke due to multiple intracranial aneurysms rupture (totally 4). Family history reported a sister died because of the same cause. The patient underwent aneurysms clipping, with a non-complicated after–surgery period. She was discharged in satisfactory general and neurological conditions. Nowadays, she undergoes a normal life, with no neurological deficit.
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Tratamiento Sistematizado de la Hemorragia Subaracnoidea
Hemorrhages account for 20% to 25% of stroke cases in our population, Among these patients, subarachnoid hemorrhage accounts for 7% to 10% of cases, and represent the main cause of stroke-related death. In the present study we present a model for systematic treatment of this condition with particular emphasis of early diagnosis and agressive therapeutic approach. We performed an observational study of 117 patients with subarachnoid hemorrhage admitted between January 1995 and August 1999 who were managed according to internationally accepted algorithms. Arterial hypertension and smoking were the most common risk factors. While angiography of intracranial vessels was performed in every patient, we could only find saccular aneurysms in 32 patients (27.36%). About 60% of those patients were operated on, with a mortality of less than 5%. Mortality was directly related to the clinical status of the patient on addmision, and aggessive therapy reduced the chance of death.
