12. Predictive Value of Glasgow Coma Scale (GCS) Scores in Patients Presenting with Spontaneous Intracerebral Hemorrhage
Muhammad Mushtaq1, Zar Khan2, Nazar Muhammad Afridi3 and Arshad Wahab Shah4
ABSTRACT
Objective: To determine the Glasgow coma scale scores in patients presenting with spontaneous intracranial hemorrhage.
Study Design: Descriptive study,
Place and Duration of Study: This study was conducted at the Department of Neurosurgery, Ayub Medical College, Abbottabad from July 2014 to June 2015.
Materials and Methods: All those patients who were between the ages of 40-70 years, who had a GCS of ≥ 5 and who had an intracranial hemorrhage for less than 72 hours duration were included in this study. All those patients with a GCS score of < 5, or who presented after 72 hours of onset of intracranial hemorrhage, or who were on anticoagulant therapy were excluded from the study. Detailed history was taken especially about hypertension, Diabetes mellitus, hyperlipidemia, lifestyle, smoking etc. and clinical examination was performed. Level of consciousness of all patients was assessed by calculating their GCS scores. All patients underwent CT scan brain (unenhanced) to confirm the intracranial hemorrhage. Data was managed and analyzed using SPSS version 21.
Results: There were 140 patients in this study. As per the gender, there were 77 males, 55%, and 63 females, 45%, representing that males were affected more than females. Mean age of study participants was 54.89±7.42 years, (range: 43 – 68 years). Age-wise stratification of patients showed that most of the patients, 52.14%, belonged to 40 – 55 years of age showing higher predilection for this age group. Mean GCS scores of the patients was 7.02±1.45. As per the blood pressure of patients, mean systolic blood pressure was 178.79±11.49 mmHg and mean diastolic blood pressure was 102.69±5.32 mmHg. Most of our patients presented with complaints of headache and vomiting followed by loss of consciousness or focal neurological deficits.
Conclusion: GCS provides valuable information regarding the level of consciousness of patients with intracerebral hemorrhage. Hypertension remains to be a common cause of stroke in our country. Large multi-centric studies should be conducted to check validity of GCS scores as well as it should be compared with new and more objective scoring systems. Masses should be educated about the risk factors leading to hypertension as well as ways to modify these risk factors so as to reduce the incidence of hypertension and improve blood pressure control in these patients. Key Words: Glasgow coma scale, intracerebral, hemorrhage
Citation of articles: Mushtaq M, Khan Z, Afridi NM, Shah AW. Predictive Value of Glasgow Coma Scale (GCS) Scores in Patients Presenting with Spontaneous Intracerebral Hemorrhage. Med Forum 2017;28(10):48-50.