CORRELACIÓN DE LA ESCALA SIRIRAJ Y HALLAZGOS RADIOLÓGICOS (TAC) PARA DIFERENCIAR SUBTIPOS DE ENFERMEDAD VASCULAR CEREBRAL

Abstract

"Siriraj scale correlation and radiological findings (CT) to differentiate the subtypes of cerebral vascular disease" Objective: Determinate the correlation between the Siriraj Index and the tomographic findings to differentiate subtypes of cerebral vascular disease. Material and methods: Analytical, cross-sectional and prospective study, in the Hospital General Regional-1, at Orizaba, Veracruz, Mexico, in the period from August 21, 2009 to June 30, 2010. The sample was not probabilistic (by convenience) for entitled patients and not entitled beneficiaries who arrived to the emergency room with the aim of determinate the diagnostic correlation of the Siriraj Index and tomographic findings to differentiate subtypes of acute cerebral vascular disease. Results: 93 patients with acute stroke syndrome were studied, with the aim of assesing the utility of the Siriraj Index to establish the differential clinical diagnosis between brain hemorrhage and brain infarction. The definitive diagnosis was corroborated with a simple lap brain computerized tomography. It was found 52 patients with brain infarction and 28 with brain hemorrhage. A high diastolic blood pressure, vomiting, headache, meningeal symptoms and coma were the most significant variables to predict brain hemorrhage; and for brain infarction, keeping consciousness level and having atheroma markers (angina, diabetes or intermittent claudication). The Siriraj index was estimated with a mathematical formula: (2.5 x consciousness level) + (2 x vomiting) + (2 x headache) + (0.1 x diastolic blood pressure) – (3 x atheroma markers) – 12. The score +1, was considered meaningful of hemorrhage, -1 of brain infarction, and between 1 and -1 doubtful for diagnosis. A sensibility of 68.9 percent was obtained for brain hemorrhage, 85.18 percent of specificity, negative predictive value of 71.4, and positive predictive value of 83.6. Brain Infarction, 71.9 percent of sensibility, 69.4 percent of specificity, negative predictive value 78.8, and positive predictive value 60.9.