RESUMO
El presente estudio tuvo como objetivo determinar la correlación entre la escala de Hunt y Hess y la escala de Fisher en la evalución de la severidad de la hemorragia subaracnoidea aneurismática y evaluó una cohorte de 30 pacientes con diagnóstico clínico, tomográfico y arteriográfico de hemorragia subaracnoidea aneurismática en el Hospital Regional III "Cayetano Heredia" de Piura del 2001-2005. La manifestaciones clínicas más frecuentes fueron cefalea (96,7%), y vómitos (70%). Utilizando la escala de Hunt y Hess, se encontró que el 46,7% (n=14) de los casos se encontró agrupados en el grado I y 33,3% (n=10) en el grado II, respectivamente. Al emplear la escala de Fisher, se encontró que el 40% (n=12) de los casos estuvo en el grado III y el 23,3% (n=7) en el grado II principalmente. Al correlacionar ambas escalas encontramos que 5 pacientes presentaron Fisher grado I, con una escala de Hunt y Hess grado I,7 de nuestros pacientes mostraron un Fisher grado II, con una escala de Hunt y Hess de grado II. Doce pacientes tuvieron Fisher grado III, con una escala de Hunt y Hess de I (n=9), II (n=2) y III (n=1), respectivamente. Finalmente, seis pacientes mostraron una escala de Fisher gardo IV, correlacionándose con una escala de Hunt y Hess de II (n=1), III (n=3), IV (n=1) y V (n=1) respectivamente (p=0,0001). La arteriografía carotidea percutánea reveló que la mayor parte de las lesiones vasculares estuvieron localizadas en la arteria comunicante posterior (56,7%). Se concluyó que existe correlación estadística entre la escala de Hunt y Hess con la escala de Fisher, siendo esta diferencia altamente significativa.
The main objective of this study was to determine the correlation between the scale of Hunt and Hess and the scale of Fisher in the evaluation of the severity of the aneurismatic subaracnoid hemorrhage and analized information of a series of 30 patients with diagnostic clinical, tomographic and arteriographic of subaracnoid hemorrhage assisted at the "Cayetano Heredia" Regional Hospital III from Piura during the period 2001 to 2005. The most frequent clinical manifestation was the migraine (96,7%) and vomits (70%). Using the scale of Hunt and Hess we were found that 46,7% (n=14) of the cases they are contained in the grade I, 33,3% (n=10) in the grade II, 13,3% (n=4) in the grade III and 3,3% were contained in the grade IV (n=1) and V (n=1) respectively. According to the severity using the scale of Fisher, they were found that 40% (n=12) this in the grade III, 23,3% (n=7) in the grade II, 20% (n=6) in the grade IV aned 16,7% (n=5) in the grade I. When correlating these scales we find that 5 patients presented grade I Fisher with a scale of Hunt and Hess I;7 of our patients showed a Fisher's grade II with a scale of Hunt and grade Hess of II. Twelve patients had Fisher grade III with a scale of Hunt and Hess of I (n=9), II (n=2) and III (n=1) respectively. Finally six patients showed a scale of Fisher grade IV being correlated with a scale of Hunt and Hess II (n=1), III (n=23), IV (n=1) and V (n=1) respectively (p=0,0001). The percotaneous carotide arteriography reveals that most of the vascular lesions were located in the posterior communicating artery (56,7%). We concluded that exists statistical correlation between the scale of Hunt and Hess with the scale of Fisher being this highly significant difference.