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KMID : 0371619990150010017
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Journal of Wonkwang Medical Science
1999 Volume.15 No. 1 p.17 ~ p.21
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Clinical Analysis of Hemiparesis in Patients with Hypertensive Thalamic and Basal Ganglionic Intracerebral Hematoma
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Moon Seong-Keun
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Abstract
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Background: The hemiparesis is a common and major problem in patients with hypertensive intracerebral hematoma. In order to define any differences between the improvements of upper and lower extremities, the author investigated the muscle strengths of paralytic extremities in patients with thalamic and basal ganglionic intracerebral hematoma which are the most common two involved sites of hypertensive intracerebral hematoma.
Method: Using the manual muscle strength test, the muscle strengths on hemorrhagic attack and 6 months later were investigated in sixty seven patients with small and medium-sized thalamic and basal ganglionic intracerebral hematoma who were admitted to the department of neurosurgery, Wonkwang university hospital from Jan. 1998 to Dec. 1998.
Results: In patients with thalamic hemorrhage, the means of motor grades of upper and lower extremities on admission were 2.8 ± 1.0 and 3.1 ± 0.9, and those six months later, 3.7 ± 0.9, 4.0 ± 0.8, respectively. In patients with basal ganglionic hematoma, the means of motor grades were as followed; upper and lower extremities on admission, 2.8 ± 0.9, 3.1 ± 0.9, and six months later, 3.6 ± 1.1, 4.4 ± 0.7, respectively. In patients with thalamic hematoma, the means of differences between the initial and follow-up motor grade were 1.0 ± 0.7 in arms and 0.9 ± 0.9 in legs, and in ganglionic hematoma, 0.8 ± 0.9, 1.3 ± 0.8, respectively.
Conclusion: Although there is a considerable improvement of hemiparesis in patients with small and medium-sized thalamic and basal ganglionic intracerebral hematoma, a significant difference exists between the improvements of upper and lower extremities. The motor weakness of lower extremities, especially in basal ganglionic hematoma, is considered to improve more remarkably than that of upper extremities.
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KEYWORD
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Hypertensive intracerebral hematoma, Hemiparesis, Arm and leg motor weakness, Pyramidal tract
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