Poor prognostics in patients with spontaneous lobar haemorrhages

ABSTRACT

The study included 30 consecutive patients presented with acute spontaneous lobar hemorrhages. Neurological deterioration was defined as a decrease in GCS sum score by two points, new neurological deficit and/or clinical signs of brain herniation. CT brain was done initially and thereafter whenever indicated. A univariate logistic regression analysis was performed. The results showed that 33.3% patients with lobar hemorrhages deteriorated after admission. In univariate analysis, only a Glasgow coma score <14 predicted deterioration [70% of deteriorates vs. 20% who did not deteriorate]. Initial CT characteristics predictive of deterioration included hemorrhage volume >60 ml [63% vs. 16%.]. Patients presented and deteriorated within 12 hours of ictus because of enlargement of hemorrhage. Those who deteriorated more than 12 hours after initial neurological symptoms showed increased mass effect secondary to edema