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KMID : 1005420030050010048
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Journal of Cerebrovascular and Endovascular Neurosurgery
2003 Volume.5 No. 1 p.48 ~ p.52
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Enhanced Focus in Hypertensive Intracerebral Hematoma on CT Scan and Hematoma Enlargement
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Doh Hong-Jik
Yim Man-Bin
Kim Eal-Maan
Lee Chang-Young
Son Eun-Ik
Kim Dong-Won
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Abstract
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Objective：Although most of hypertensive intracerebral hematoma (HICH) are static after ictus, a minority of them can enlarge in the acute phase after onset. This study performs to find the predicting factors and signs of hematoma enlargement in patients with HICH.
Methods：Among 140 cases of HICH treated during 1.5 years, the authors selected 107 cases who underwent contrast enhanced and nonenhanced initial CT scanning within 12 hours after symptom onset and a follow-up CT scan in order to investigate the enlargement of hematoma. Those cases were divided into two groups：hematoma enlargement (group I) and non-enlargement group (group II). The comparison of predicting factors (bleeding tendency, abnormal liver function and blood pressure) and signs (enhanced focus in hematoma on CT) of hematoma enlargement between group I and II was performed.
Results：There were 8 cases in group I and 99 cases in group II. The incidence of an enhanced focus in hematoma on CT scan was higher in group I than group II (87.5% vs. 9.1%, p<0.05). The systolic blood pressure (BP) at 6 hours after symptom onset and at the time of the first CT scan was higher in group I than group II (172.5 vs. 152.0 mm Hg, and 182.5 vs. 158.6 mm Hg, respectively, p<0.05). There was no difference in the incidence of bleeding tendency and abnormal liver function between group I and II.
Conclusion：Contrast enhanced brain CT scan to detect the enhanced focus in the hematoma is one of useful methods to predict the early enlargement of hematoma in patients with HICH. The continuance of a high BP in spite of medication of antihypertensive drugs during the acute period after the onset of symptoms is another predictive sign of hematoma enlargement in patients with HICH.
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KEYWORD
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Hypertensive intracerebral hematoma, Computerized tomography, Enhanced focus, Hematoma enlargement,
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