急性期診療における軽症脳出血の臨床的評価

概要

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It seems very important to predict the prognosis of putaminal hemorrhage immediately after the ictus for the decision of indication of emergency surgery. For this purpose, the authors investigated the natural course of 52 patients of putaminal hemorrhage who were admitted to our survice within 6 hours after ictus.<BR>The level of consciousness which has been said as a good parameter for the prediction of the prognosis did not have direct correlation with the outcome after 3 months of onset in those acute cases. Even in the cases of mild impairment of consciousness, there was 39.4% death. However, the size of hematomas evaluated on angiograms predicted the prognosis considerablly well. Large hematomas showed poor prognosis which followed very rapid deterioration in most of cases, even if the patients were alert or in mild disturbance of consciousness. On the other hand, small hematomas brought good prognosis except for one case of rebleeding.<BR>Consequently, the cases with large hematomas should be operated upon as soon as possible even though they were alert immediately after the ictus, and small hematoma should not be treated surgically, because they indicated good prognosis generally.