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KMID : 1150320060020010068
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Journal of Korean Society of Geriatric Neurosurgery
2006 Volume.2 No. 1 p.68 ~ p.74
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Classification of Hypertensive Thalamic and Basal Ganglia Hemorrhage by Computer Tomography: Outcome and Factors Affecting Prognosis
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Kim Moon-Kyu
Lee Tae-Kyu
Yang Seung-Ho
Park Chun-Kun
Kim Moon-Chan
Kang Joon-Ki
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Abstract
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Objective: We analyzed outcomes of patients with ganglionic-thalamic hemorrhage in the elderly group (older than 55 years old).
Methods: Patients (n=26, M:F=18:8, admitted at our hospital from August 2003 to August 2004) with hemorrhagic stroke in the thalamus and the basal ganglia were included [ less than 5cm in th maximal hematoma dirneter). Lesion locations were evaluated by Computed Tomotraphy (CT) scan immediately after the ictus. Patients were divided into 4 groups according to the location of lesion (anterior thalamic, posterior thalamic, anterolateral, posterolateral) and were accessed by Glasgow Outcome Scale(GOS), Weakness, Glasgow Coma Scale(GCS) after the complete hematoma resolution.
Results: Sixteen patients were treated medically and 10 patients who had lager than 3cm in diameter or acute hydrocephalus underwent surgical treatment including ventriculostomy or navigation guided aspiration. Hematomas were located in the anterior thalamus 3(11.5%), anterolateral 10(38.5%), posterior thalamus 9(34.6%) and posterolateral 4(15.4%). Patients who showed GOS more than 4 in anterior thalamic group, in anterolateral group, in posterior thalamic group and in the posterolateral group were 66.7%(2/3), 66.7%(2/3), 50%(5/10) and 60% (6/10), respectively.
Conclusion: Most basal ganglia hematomas were located in the anterolateral and posterior thalamus. The anterior group showed better GOS than those of posterior and posterolateral group, and th GOS showed correnlation with the intraventricular hcmorrhage(1VH), hcmatoma size, initial GOS, and location.
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KEYWORD
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Hemorrhage, Computed Tomography(CT), Thalamus, Basal ganglia, prognsis
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