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Journal of Korean Neurosurgical Society 1990;19(2): 180-187.
Prognosis of Spontaneous Intracerebral Hemorrhage.
Yong Jae Lee, Kyeong Seok Lee, Hack Gun Bae, Il Gyu Yun, In Soo Lee
Department of Neurosurgery, Soonchunhyang University Chonan Hospital, Chonan, Korea.
A series of 497 patients with spontaneous intracerebral hemorrhage was analyzed. All were admitted to the Soonchunhyang University Chonan Hospital from January 1985 to December 1988 and diagnosed by CT. The age distribution showed the highest peak of incidence at sixth decade(37.8%), followed by the seventh(26.8%), fifth(19.7%), eighth(9.5%), and fourth(3.4%) decades in that order. Our series consisted of 217 males and 280 females. The hemorrhages were located in the putamen in 41.4%, thalamus in 27.2%, cerebrel hemisphere in 14.3%, cerebellum in 6.4%, brain stem in 3.8% and others in 6.8%. Glasgow coma scale on admission is 13-15 in 44.1%, 3-8 in 30.8% and 9-12 in 25.2%. Surgical treatments were performed in 200 patients and 297 patients were treated conservatively. Surgical treatments were usually performed in comatose patients, while vast majority of alert patients were treated conservatively. Surgical mortality rate was 54.0% and mortality rate of conservatively treated patients was 26.9%. Overall mortality rate was 39.8% expect self-discharged or transferred patients(26.2% of total). The outcome was good recovery in 12.5%, moderate disability in 27.5%, severe disability or vegetative state in 20.2% and death or moribund-discharge in 39.8%. The prognosis was related to the level of consciousness and the location of hemorrhage. Age, sex, and method of treatment did not affect the prognosis significantly. There was no evidence that outcome of surgical treatment was better than of conservative treatment in this study.
Key Words: Spontaneous intracerebral hemorrhage; Prognosis; Hypertension; CT
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