Search

The aim of this study was to determine the factors that influence the prognosis of hypertensive putaminal hemorrhage. We investigated the outcome of the activity of daily living (ADL 1: full recovery at social life, 2: self cared, 3: required partial care at home, 4: remained bedridden, 5: vegetative state, 6: dead) one year after the onset of putaminal hemorrhage in comparison with initial data obtained on the day when it occurred. The following parameters were assessed: sex, age, side of hematoma, classification of computed tomography (CT) findings, neurological grade, degree of muscle power, hematoma volume, treatment, past history of cerebrovascular disease, and laboratory data. In 67 patients with putaminal hemorrhage, the relationships among these parameters were examined using Spearman's rank correlation analysis. Additionally, in 55 patients (24 male and 31 female) with complete data from the day of onset, multiple regression analysis was performed. The data of muscle power were handled by the quantification method. The result of Spearman's rank correlation coefficient indicated that the outcome had a positive correlation with age (correlation coefficient = 0.375), CT classification (0.595), neurological grade (0.714), hematoma volume (0.689), a past history of cerebrovascular disease (0.475), the white blood cell count (0.541), and the lactate dehydrogenase level (0.347). The outcome had a negative correlation with muscle power (-0.579) and the cholinesterase (-0.340).(ABSTRACT TRUNCATED AT 250 WORDS)

The present study deals with the factors affecting the prognosis in the acute stage of 29 cases with hypertensive thalamic hemorrhage diagnosed by CT scan. It was thought that the following factors were significantly related to the outcome of the patients who were unable to lead daily life, remained in vegetative state or died. (1) Consciousness level was below 10 in the so-called 3-3-9 formula. (2) Bilateral Babinski's signs was observed. (3) Localization of the hematoma was all the thalamic nuclei type. (4) Hematoma volume was above 10 ml. (5) As for the size of hematoma, the maximum dimension of hematoma was over 30 or 35 mm, maximum width over 30 mm, maximum length over 25 mm and maximum height over 30 or 40 mm. (6) Ventricles were dilatated. It was seemed that the prognosis had no significant relationship with the age of the patients, the difference between left and right side of hematoma, with the presence or the absence of ventricular penetration of hematoma, and with the existence of midline shift. We thought that in the acute stage of hypertensive thalamic hemorrhage of the prognosis could be forecasted by neurological findings, accurate calculation of the hematoma volume and size, localization of hematoma and presence or absence of ventricular dilatation by CT scan.