急性期脳血管障害の予後決定因子

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Fatal factors in the acute stage of a stroke were studied with a series of 141 patients admitted to Kitasato University Hospital within 10 days after onset from July, 1971 to June, 1974. Results obtained were as follows: Mortality rates of cerebral hemorrhage, subarachnoidal hemorrhage, cerebral thrombosis, cerebral embolism and transient ischemic attacks were 65.5% (19/29), 14.3% (4/28), 7.5% (5/67), 16.7% (1/6) and none (0/6), respectively. Survival times after onset in the fatal cases of intracranial hemorrhages were very short, usually less than 10 days, and respiratory arrest due to brain stem damage was the direct cause of death in these cases. On the other hand, no fatal case was observed in the acute stage of cerebral infarction, while 6 of 74 patients died of various complications, especially pneumonia, in the chronic stage of the disease. Of 29 patients with cerebral hemorrhage, those who showed clinical signs of mid-brain damages, such as anisocoria, loss of pupillary reflexes, hyperventilation or decerebrate rigidity, died of respiratory arrest in the acute stage without exception; however, those who did not have any sign of mid-brain damage were all alive and had favorable prognosis. From these observations, it can be concluded that fatality in the acute stage of cerebral hemorrhage depends upon the occurrence of mid-brain damage caused by rupture of hematoma into the ventricles, uncal herniations, and/or secondary hemorrhages in the brain stem.
北里大学の論文
1976-08-31

急性期脳血管障害の予後決定因子

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