脳室穿破CT像からみた基底核部出血の分類と予後

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The prognosis of hypertensive intracerebral hemorrhage is related not only to the location, the spreading and the direction of hematoma, but also to the ventricular hemorrhage. It is regarded as the most worst complication of an intracerebral hemorrhage. On computerized tomography (CT), there are various type of ventricular hemorrhage. We classify them into three types and discuss the prognosis of basal genglionic hemorrhage from the type. Thirty-six cases are observed on CT; 20 cases of ventricle rupture and 16 cases of non-ventricle repture. In the former, 7 patients are dead and in the latter, all have a useful life.<BR>Type 1: Hemorrhagic nibeau (clot) in the posterior horn of unilateral or bilateral lateral ventricle and no hemorrhage (clot) in third ventricle.<BR>Type 2: Hemorrhage (clot) near the Monro's foramen in lateral ventricle and nibeau in the posterior horn of another lateral ventricle and occasional hemorrhage (clot) in third ventricle.<BR>Type 3: Hemorrhage (clot) fully in one lateral ventricle and around the Monro's foramen in another lateral ventricle and constant hemorrhage in third ventricle.<BR>In type 1. one of 7 cases is dead. The case is delirious state and has combined type of rt. intracerebral hematoma. Right cintinuous ventricular drainage (CVD) is performed but obstructed by clot after a few days. Ventricle rupture of small hematoma belongs to this type. The cases removed hematoma go on well. In type 2. three of 9 cases are dead. CVD sometimes don't work well. Removal of hematoma is not always effective. In type 3, three of 4 cases are dead. This hemorrhage forms the so-called ventricular cast. CVD or removal of hematoma is not useful. However, only on case is saved. To this combined type of hematoma, bilateral CVD is performed and 100 thousand units of urokinase is inserted into it. In conclusion, ventricle hemorrhage is sometimes observed in mild cases. According to amount of hemorrhage, parients become to be servere. This classification of ventricle hemorrhage is valuable to speculate the prognosis of basal ganglionic hemorrhage.

脳室穿破CT像からみた基底核部出血の分類と予後

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