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Traumatic Subarachnoid Haemorrhage (Paperback)
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Traumatic Subarachnoid Haemorrhage (Paperback)
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In the last few decades an abundance of publications have accumu
lated on the clinical implications of subarachnoid haemorrhage
(SAH) due to aneurysmal rupture. In contrast, until about 6 years
ago, SAH due to traumatic head injury mainly, if not only, drew the
attention of the forensic pathologist. In their analysis of the
data from the American Traumatic Coma Data Bank, Eisenberg et al.
concluded in 1990 that the presence of SAH on the initial computed
tomographic scan (tSAH) had an un favourable effect on outcome.
This conclusion has since been con firmed in other series. Dr.
Kakarieka, the author of the present monograph, has been fascinated
by tSAH since his participation in 1989 as International Trial
Coordinator of the large European Trial on the effect of nimodipine
on outcome after severe injury (HIT 2). This study re vealed a
statistically significant, favourable effect in the subgroup of
patients with tSAH, a result which warranted a further trial on the
efficacy of nimodipine administration in patients with tSAH. This
trial, the so-called German trial which was completed in 1995, not
only revealed that tSAH is an important and independent factor
predicting unfavourable outcome in head injury, but also showed
convincingly the statistically significant, favourable effect of
nimodipine adminis tration in patients with tSAH."
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