Prognostic value of site and size of intracerebral hematoma

ABSTRACT

We studied 40 patients presented with spontaneous intracerebral hemorrhage [ICH]. Site and size of the lesion were determined by computed tomography, and the outcome in a month period was clinically evaluated. Thalamic lesions were always small [100 percent], and basal ganglionic lesions were more often small [62.5 percent] than lobar hematomas [31.57 percent]. Medium and large hematomas were common in lobar sites. Peri-focal edema was more common in basal ganglionic lesions, medium and large hematomas while mass effect was common in lobar and large sized hematomas. Significant difference was found between survivors [15 percent good, 32.5 percent fair, 15 percent poor outcome] and fatalities [37.5 percent]. Mortality was higher in large size hematoma [66.7 percent], followed by medium [40 percent] and small ones [23.8 percent]; and was higher in lobar lesions [47.4 percent], especially temporal sites [80 percent], followed by basal ganglionic [31.3] and thalamic [25 percent].Edema and mass effect were more detected in fatal cases. So, the presence of perifocal edema and mass effect in a large volume lobar hematoma [especially temporal] are poor outcome predictors in ICH