The Ewha Medical Journal
Ewha Womans University School of Medicine
Original Article

Clinical Analysis of Hypertensive Intracerebral Hemorrhage

Sung Hak Kim
Corresponding author: Sung Hak Kim. Department of Neurosurgery, College of Medicine, Ewha Womans University, Korea.

Copyright ⓒ 1983. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Jul 24, 2015

Abstract

We have experienced 61 cases of hypertensive intracerebral hemorrhage who were admitted to the Department of Neurosurgery of Ewha Womans University Hospital from January 1981 to October 1983.

We analyzed the result of the treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the result of treatment of hypertensive intracerebral hemorrhage.

The following results were obtained.

1) The age distribution was ranged from 36 to 74, and the fifth decade was most frequently involved, 22 among 61 patients(36.1%).

2) The ratio of male to female was about 1.8:1 and the age of the patient did not significantly influence on the result of operative cases in all age group, but in the non-operative cases increased mortality above fifth decade was noted.

3) The most frequent site of hypertensive intracerebral hemorrhage was putamen in 50.8%; followed by thalamic 19.7%, subcortical 11.5%, pontine 9.8% and cerebellar hemorrhage 8.2%. Intraventricular hemorrhage occurred in 27.2%.

4) Calculated amounts of hematoma based on CT scans ranged from 5 to 150cc roughly. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma was less than 65cc, while the mortality was considerably increased if the hematoma was more than 65cc.

5) In correlation between arterial blood pressure and outcome, the mortality of below systolic BP 150mmHg was 20%, of above BO 150mmHg was 41.3%.

6) The operative mortality of the hypertensive intracerebral hemorrhage was 27.8%, and 48% in non-operative cases.

7) The surgical treatment obtained better result than non-operative treatment in the cases showing progressive change in consciousness following intracerebral hemorrhage and the conservative treatment obtained relatively good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage.

8) The interval from the attack to surgical intervention did not constantly influence on the result of surgery and it might be wise to decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding.