Prognostic Factors in Patients with Hypertensive Basal Ganglionic - Thalamic Intracerebral Hemorrhage

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.

Prognosis of Primary Subarachnoid Hemorrhage

A clinical analysis and follow-up study were performed with 35 cases of subarachnoid hemorrhage of unknown etiology among 217 cases of spontaneous subarachnoid hemorrhage who were diagnosed by cerebral pan-angiohraphy and brain C-T scan and treated at department of neurosurgery, Chonju Presbyterian Medical Center from 1977 to 1982. The duration of follow-up study was 6 months to 8 years(mean 4.4years). The author obtained the following results. 1) Subarachnoid hemorrhage of unknown etiology was 16% of 217 cases of spontaneous hemorrhage. 2) The incidence of subarachnoid hemorrhage of unknown etiology was high in 5th decade and higher in women. 3) Manifestations of subarachnoid hemorrhage of unknown etiology were similar to those of ruptured aneurysm. 4) When primary cerebral pan-angiography was normal, the secondary cerebral pan-angiography was not so meaningful. 5) The overall prognosis of the cases of unknown etiology was good in 30 among 35 cases(86%) who were able to return to their previous occupation. 6) Age and blood pressure were probably major prognostic factor.

Sylvian Lipoma: Case Report

Intracranial lipomas are rare tumor which are usually found along the midline cerebral cisterns. A case of sylvian lipoma located usually at sylvian fissure was diagnosed by CT scanning and was confirmed with operation. Only partial resection could be done. The literature was reviewed and therapeutic options are proposed.