高血圧性脳内出血の診断:-EMI所見を中心に-

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We experienced 37 patients with hypertensive intracerebral and posterior fossa hemorrhage during last 8 months. We analized the sites of hemorrhage in all patients based on CT and angiographic findings and we could devide them into 18 putaminal, 12 thalamic, 4 subcortical, and 3 cerebral hemorrhages. 2 to 3 days after hemorrhage, a low density zone was seen at the anterior and posterior poles of the intracerebral hematoma. About 5 days after, intracerebral hematoma was present with thick surrounding zone of edema and then gradually decreased in size of the high density hematoma with a wide zone of surrounding low density of liquefied hematoma and/or edema over 15-days period. We classified the putaminal and thalamic hemorrhages into each 3 types. Putaminal hemorrhage; Type 1: showing under 3-cm diameter high density. 1a: localized in the putamen and not extending into the internal capsule. 1b: extending into the part of the internal capsule. Type 2: showing over 3-cm diameter high density. 2a: extending into the part of the internal capsule. 2b: anterior-posterior extension with extension into the internal capsule. Type 3: extending into the thalamus with destruction of the internal capsule and/or a large high density in the ventricles (ventricle tamponade). Thalamic hemorrhage; Type 1: localized in the internal or external nuclei. Type 2: a large high density in the thalamus with extention into the part of the internal capsule or perforating into the ventricle. Type 3. larger high density of anterior-posterior-lateral extension with destruction of the internal capsule and/or ventricle tamponade.
The Japanese Society on Surgery for Cerebral Strokeの論文

高血圧性脳内出血の診断:-EMI所見を中心に-

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