The Factors Affecting Enlargement of Spontaneous Intracerebral Hemorrhage

OBJECTIVE: The goal of this study is to evaluate the incidence and factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). METHODS: We analyzed 149 cases with spontaneous ICH who underwent computerized tomography (CT) scans from January, 1995 to December, 1998. The clinical characteristics, past medical history, laboratory findings, time intervals between onset of ICH and CT scan, CT findings and results of treatment were reviewed. RESULTS: Of the total 149 patients, 28(18.8%) had hematoma enlargement, of whom 24(85.7%) underwent a first CT scan within 3 hours after onset of ICH. The incidence of hematoma enlargement significantly decreased in patients who had CT scans 3 hours later after attack. Age, sex, and site of hematoma were not related to hematoma enlargement. Patients with an irregularly shaped hematoma, inhomogenous hematoma and large hematoma had a high risk of hematoma enlargement. Hematoma enlargement was associated with a poor clinical outcome and high mortality(46.7%). CONCLUSION: Patients admitted to a hospital within 3 hours of onset of ICH, and patients with inhomogenous hematoma on CT scan, irregularly shaped hematoma, or large hematoma should be closely observed for hematoma enlargement.

Comparison of Fluid-Attenuated Inversion-Recovery Magnetic Resonance Imaging with Computed Tomography in Acute Intraventricular Hemorrhage

OBJECTIVE: Our aim is to evaluate the usefulness of fluid-attenuated inversion recovery(FLAIR) magnetic resonance(MR) imaging for detection of acute intraventricular hemorrhage(IVH) compared with pre-contrast computed tomography(CT). METHODS: Twenty-eight patients with acute IVH were evaluated with FLAIR MR imaging and precontrast CT. All MR and CT examination were performed within two days from symptom onset. One neurosurgeon and one radiologist evaluated the detectability and conspicuity of acute IVH on FLAIR MR imaging and pre-contrast CT. RESULTS: Acute IVH was detected in all patients on FLAIR MR imaging and in 23(82%) of 28 patients on pre-contrast CT. The conspicuity of IVH on FLAIR MR imaging was as good as or better than that on pre-contrast CT in 28 patient. CONCLUSION: It is suggested that FLAIR MR imaging is superior to pre-contrast CT in the diagnosis of acute IVH.