高血圧性脳出血とくに被殻出血の外科的治療における予後因子(B 臨床的研究)

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During the period from 1976 to 1980,42 hypertensive intracranial hemorrhage patients were surgically treated. They consisted of 26 putaminal hemorrhage cases, 9 cerebral subcortical, 5 thalamic, and 2 cerebellar hemorrhage cases. In contrast to the favorable surgical results for subcortical and cerebellar hematomas, the functional prognosis of putaminal hemorrhage remains much to be improved. The surgical results for putaminal hematoma were as follows : mortality rate 31% (within 1 month), good ADL (Activity of Daily Life, 6 months postoperatively 31%, and poor ADL 38%. Clinical studies on the surgically treated putaminal hematoma cases and 45 conservatively treated cases in our affiliated hospital have been done. The observations are as follows. In the conservative therapy group, the functional prognosis of patients whose hematoma volumes were less than 30-40 cc showed good correlation to the hematoma volume. Those whose hematoma volumes were more than 30-40 cc however, gave poor vital prognosis. Among the surgically treated patients, the correlation between hematoma volume (average 57 cc) and both preoperative neurological grading and postoperative ADL grading was not observed, but good correlation between distance of midline shift on CT and neurological grading was demonstrated. Although no good evidence of favorable early operation was shown, delay in operation from the time zone when the clinical condition of each case turned downhill resulted in bad vital and functional prognosis. Hypernatremia patients with hematoma showed poor vital prognosis and hyponatremia worsened functional prognosis.
近畿大学の論文
1981-09-25

高血圧性脳出血とくに被殻出血の外科的治療における予後因子(B 臨床的研究)

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