Clinical Analysis of Operative Treatment in 60 Cases Hypertensive Intracerebral Hemorrhage.

Kim, D H; Lee, S H; Park, K H; Kim, C C; Kim, D J

Original Article

Journal of Korean Neurosurgical Society 1983;12(3): 391-400.

D H Kim, S H Lee, K H Park, C C Kim, D J Kim

Department of Neurosurgery, Maryknoll Hospital, Busan, Korea.

ABSTRACT

We have surgical experiences in 60 cases of hypertensive intracerebral hemorrhage who were admitted to Maryknoll Hospital from March 1981 to February 1983. All cases were diagnosed by clinical history, cerebral angiography, brain CT and analyzed the prognostic elements on treatment. The results were as follows : 1) Age distribution was ranged from 2nd decade 7th decade, the 5th decade was the most frequently involved. The ratio of male to female was 2.75 : 1. 2) In morphological classfication of hematoma, lateral type(26 cases), subcortical type(19 cases), quadrilateral type(10 cases), medial type(5 cases) in order. 3) In correlation between site of hematoma and outcome, the surgical mortality of subcortical type was 21%, of lateral type was 23%, of quadrilateral type was 80%, of medial type was 100%. 4) In correlation between ventricular hemorrhage and outcome, the surgical mortality of ventricular hemorrhage(-) was 17.8%, of ventricular hemorrhage(+) was 56.3%. 5) In correlation between volume of hematoma and outcome, more mortality rate in large volume of hematoma than small volume of hematoma. 6) In correlation between level of consciousness and outcome, the surgical mortality of Grade I(alert) was 0%, of Grade II(drowsy) was 9.1%, of Grade III(stupor) was 38.5%, of Grade IV(semicoma) was 44.4%, of Grade V(coma) was 81.3%. 7) In correlation between arterial blood pressure and outcome, the surgical mortality of below systolic BP 150mmHg was 25%, of above BP 150mmHg was 43.2%. 8) In correlation between time interval from ictus operation and site of hematoma and outcome. In early operation(within 72 hours operation), the surgical mortality of medial group was 85.7%, of lateral group was 29.4%, of subcortical group was 36.4%. In later operation(72 hours later operation), the surgical mortality of medial group was 100%, of lateral group was 11.2%, of subcortical was 0%. 9) In correlation between time interval from ictus till operation and level of consciousness and outcome. In relatively good consciousness, the surgical mortality of early operation was 23.5%, of late operation was 12.5%. In bad consciousness, the surgical mortality of early operation was 68%, of the late operation was 100%.

Key Words: Hypertensive intracerebral hemorrhage; Brain CT scan; Prognostic elements; Early surgery; Late surgery; Surgical mortality