遠隔時の機能予後よりみた高血圧性脳出血の脳血管写診断

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In 1973 the authors reported that at three months after surgery the prognosis of hemimotor disturbance of the patients with hypertensive intracerebral haemorrhage has a good correlation with the angiographic classification of haematomas in the preoperative lateral angiograms and concluded that the patients with the suprasylvian type haematomas have an excellent prognosis, those with the infrasylvian type haematomas a good, and those with the intrasylvian type haematomas a poor prognosis. This result was considered to be due to the degree and the site of destruction of the internal capsule due to haematomas.<BR>In this paper we investigated the follow-up prognosis of hemimotor disturbance accoding to the activities of the patients with this disease in their daily living (ADL) at 6 months and one year after surgery. This study is based upon the analysis of the well group (full work and minimally disabled) which consists of 17 cases at 6 months and 15 cases at one year after surgery and 10 totally disabled cases at one year postoperatively.<BR>The results obtained from this study are as follows:1 )The major significant factors influencing the postoperative recovery of disabled limbs under the long-term observation are location of haematomas (supra-, intra-, and infrasylvian types) and the presence of the angiographic sign of transtentorial herniation; 2) whether herniation is reversible or not is another important factor in each type of haematoma location; 3) The depth of haematoma from the cortex is also an influencing factor upon the prognosis in the supra-and infrasylvian type haematomas; 4) age factor and complications during hospital stay also play an important role for the postoperative prognosis.
The Japanese Society on Surgery for Cerebral Strokeの論文

遠隔時の機能予後よりみた高血圧性脳出血の脳血管写診断

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