Multiple hypertensive intracerebral hematomas which occurred simultaneously.
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Two cases of multiple hypertensive intracerebral hematomas which occurred simultaneously are presented. The first case is 89-year-old with 10 years history of hypertension. He suddenly suffered from disturbance of consciousness and was admitted with comatose state. A CT scan taken within 4 hours after the onset revealed a large high density area in the right putaminal region and a small high density area in the left putamen with massive ventricular hemorrhage. Considering his age and neurological grading, he was not indicated for direct surgery. However his family asked for surgery, so the aspiration surgery was performed, but 4 days after the onset he died due to acute cardiac failure. The other case is 66-year-old-man with history of hypertension. He was transfered with comatose state. A CT scan taken within 2 hours after the onset disclosed high density areas in the left thalamus, in the right cerebellum and in the brain stem with intraventricular hemorrhage. Bilateral ventricular drainages were performed and he was treated conservatively. However, 11 days after the onset he died.<BR>The incidence of bilateral hypertensive intracerebral hematomas is reported as 1.5% and 9.5%. The advent of CT scan has made it easy to diagnose multiple hypertensive intracerebral hematomas, however, its simultaneous occurrence is still rate.<BR>We collected 27 cases of simultaneously occurring multiple intracerebral hematomas. Twelve cases were male and 15 were female. The age of the patients ranged from 42 to 89 years. Fifty-five hematomas of 27 cases distributed to 26 in putamen, 12 in thalamus and 17 in other regions. The clinical symptoms of multiple hypertensive intracerebral hematomas are severe and prognosis of these patients is poor. The mechanism and indication for surgery of multiple hypertensive intracerebral hematomas were discussed.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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