We have experienced 61 cases of hypertensive intracerebral hemorrhage who were admitted to the Department of Neurosurgery of Ewha Womans University Hospital , from January 1981 to October _ 1983.
We analyzed the result of the treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the result of treatment of hypertensive intracerebral hemorrhage.
The following results were obtained.
1) The age distribution was ranged from 36 to 74, and the fifth decade was most frequently involved, 22 among 61 patients ( 36.1 %) .
2) The ratio of male to female was about 1.8: 1 and the age of the patient did not significantly influence on the result of operative cases in all age group, but in the non-operative cases increased mortality above fifth decade was noted.
3) The most frequent site of hypertensive intracerebral hemorrhage was putamen in 50.8%; followed by thalamic 19.7%, subcortical 11.5%, pontine 9.8% and cerebellar hemorrhage 8.2%. Intraventricular hemorrhage occurred in 27.2%.
4) Calculated amounts of hematoma - based on CT scans ranged from 5 to 150 cc roughly. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma was less than 65 cc, while the mortality was considerably increased if the hematoma was more than 65 cc.
5) In correlation between arterial blood pressure and outcome, the mortality of below- systolic BP 150mmHg was 20%, of above BP 150mmHg was 41.3%.
6) The operative mortality of the hypertensive intracerebral hemorrhage was 27.8 % and 48% in non- operative cases.
7) The surgical treatment obtained better result than nonoperative treatment in
the cases showing progressive change in consciousness following intracerebral hemorrhage and the conservative treatment obtained relatively good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage.
8) The interval from the attack to surgical intervention did not constantly influence on the result of surgery and it might be wise to "decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding.
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