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Journal of Korean Neurosurgical Society > Volume 32(6); 2002 > Article
Journal of Korean Neurosurgical Society 2002;32(6): 564-569.
The Factors Affecting Enlargement of Spontaneous Intracerebral Hemorrhage.
Hak Yong Kim, Jin Ho Mok, Hyeong Keun Park, Kyu Chun Lee, Yong Seok Park, Young Bae Lee
Department of Neurosurgery, College of Medicine, Dong Guk University, Gyeongju, Korea. mokjh@chollian.net
The goal of this study is to evaluate the incidence and factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH).
We analyzed 149 cases with spontaneous ICH who underwent computerized tomography (CT) scans from January, 1995 to December, 1998. The clinical characteristics, past medical history, laboratory findings, time intervals between onset of ICH and CT scan, CT findings and results of treatment were reviewed.
Of the total 149 patients, 28(18.8%) had hematoma enlargement, of whom 24(85.7%) underwent a first CT scan within 3 hours after onset of ICH. The incidence of hematoma enlargement significantly decreased in patients who had CT scans 3 hours later after attack. Age, sex, and site of hematoma were not related to hematoma enlargement. Patients with an irregularly shaped hematoma, inhomogenous hematoma and large hematoma had a high risk of hematoma enlargement. Hematoma enlargement was associated with a poor clinical outcome and high mortality(46.7%).
Patients admitted to a hospital within 3 hours of onset of ICH, and patients with inhomogenous hematoma on CT scan, irregularly shaped hematoma, or large hematoma should be closely observed for hematoma enlargement.
Key Words: Hematoma enlargement; Intracerebral hemorrhage; Factors
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