Analysis of CT Findings and Results of Treatment of Hypertensive Intracerebral Hemorrhage.

Kang, Y W; Kim, T Y; Rhee, B A; Leem, W

Original Article

Journal of Korean Neurosurgical Society 1981;10(1): 113-124.

Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea.

ABSTRACT

The result of the treatment of hypertensive intracerebral hemorrhage in 40 cases, who admitted to the Kyung Hee Medical Center from October 977 to February 1981, are analyzed with the correlation to the CT findings. The followings results were obtained. 1) In the age distribution, the 6th decade was most frequently involved, 12 among 40 patients(30%). 25 cases were male and 15 cases were female. 2) The most frequent site of hypertensive intracebral hemorrhage was putamen in 40%; followd by subcortical 30%, thalamic 15%, cerebellar 7.5%, and pontine 7.5%. Intraventricular hemorrhage occurred in 27.5%. In morphological classification of the hematoma on CT scans, the most frequent type of putaminal hemorrhage was type 3, in 56%, and the most frequent type of thalamic hemorrhage was type 2A and type 3, respectively in 33%. 3) Calculated amounts of the hematomas based on CT scans ranged from 3 to 311 cc. The averages were 119cc in the putaminal hemorrhage, 79cc in the thalamic hemorrhage, 102cc in the subcortical hemorrhage, 51cc in the cerebellar hemorrhage and 13cc in the pontine hemorrhage. 4) On the basis of the morphological classification, the fact, that the operation was done or not, had not influenced on the outcome, but the type had relatively constant relation ship with the outcome. 5) When the hematoma was less than 100cc, the result was favorable in the cases of the stage of O or I at the operated and the non-operated, but in the cases of stage of III, the operated cases showed the better outcome than the non-operated cases. When the amount of the hematoma of the hemorrhage was over 100cc. The result was favorable after the operation in the cases of the stages O or I, but in the cases of the stage III, all patients died after the operation. 6) It may be preferable to decide the time of the operation according to the progressive changes in the conscious level and neurological findings.