大脳基底核部高血圧性脳内出血:-重症型の手術適応-

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Authors have studied hypertensive intracerebral hemorrhage in basal ganglial area in various aspects clinically and statistically. We reported that there was a high correlation between the outcome and each of stage in an acute phase, amount of hematoma and our morphological classification based on CT findings. According to these highly correlated factors, we decided 4 grades in an acute phase.<BR>In this report, we studied the surgical indication for the serious type which number was 53 out of 133 of hypertensive intracerebral hemorrhage in basal ganglial area (27 cases in grade IV and 26 cases in stage IIIc-e of grade III). The survival outcome of surgical group was better than that of non surgical group, but neither of two groups were good in functional outcome. Studying of each stage, all cases in stage IIIe with semicomatose or comatose state and with decerebrate rigidity resulted in death without one case of vegetative state. Mortality of surgical cases in stage Ed was 57%and that of non surgical cases in the same stage was 71%. Cases in stage IIId and stage IIIc recovered to daily life partially assisted.<BR>We concluded that patients in stage IIIe were difficult to be saved even if surgery was carried on, and it wasn't evaluated socially to elongate the term from onset to death by surgery (the term of surgical group was 17.8 days and that of non surgical group was 2.6 days.). So the serious type of hypertensive intracerebral hemorrhage in basal ganglial area, surgery should be carried out before patients fall into stage IIIe.

大脳基底核部高血圧性脳内出血:-重症型の手術適応-

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