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Objective To discuss the clinical features and treatment measures on patients with medium volume of supratentorial hypertensive cerebral hemorrhage in the elderly.Methods The clinical data of 57 patients with medium volume of supratentorial hypertensive cerebral hemorrhage aged ≥ 70 years were analyzed retrospectively.Results All of 57 patients,15 cases accepted medical treatment,42 cases were treated with minimally invasive operation for 1-26 (4.6 ± 6.5) h after onset.Three cases died in hospital,7 cases were transferred or gave up,6 cases lived as plant,8 cases were severely maimed,11 cases were moderately maimed,22 cases [38.6％(22/57)] recovered favorably.The main clinical characteristics of elderly patients:long history of hypertension,blood pressure fluctuation; atypical symptoms of increased intracranial pressure; more complications such as arrhythmia and pulmonary infection; most of family members of patients were pessimistic to treatment.Conclusions All factors should be thought over about the treatment of elderly patients with medium volume of hypertensive cerebral hemorrhage.Individual treatment is reasonable.Do not emphasize on early operation,minimally invasive operation can be helpful for patients.
RESUMO
Objective To investigate effects of hypertensive agents on regional cerebral blood flow (rCBF)and prognosis in patients with hypertensive intracerebral hemorrhage (HICH). Method Thirty patients withFILCH were divided into group A,B and C according to mean arterial pressure(MAP) with various ranges of <10%, 10 ～ 20%, and > 20%, respectively. Patients of three groups were checked with single photon emissioncomputed tomography (SPECT),and computerized tomography of head successively, 24 hours, 3 ～ 5 days, and 12～ 15 days after admission for the assessment of therapeutic effects. The rtes of the decrease in rCBF compared be-twecn groups were analyzed with t test. Neurologic function defect scale, activities of living scale and number of re-bleeding compared between two groups were analyzed by X2 test, respectively. Results There were statisticallysignificant differences in the rate of the decrease in rCBF. The neurologic function defect scale and activities of liv-ing scale at 24 hours, 3 ～ 5 days, and 12 ～ 15 days after admission compared between group C and group A, andbetween group C and group B showed significant differences ( P < 0.05). There were statistically significant differ-enees in rebleeding during acute phase of HICH between group A and group B or group C (P < 0.05).Conclusions If the systolic blood pressure is above 185mmHg or diastolic blood pressure over 95mmHg,it is ra-tional and safe to lower the MAP by about 15% with hypotensive gents so as to minimize the impact on regionalcerebral blood flow.