Outcome after Medical Treatment for Hypertensive Intracerebral Hemorrhage

ABSTRACT

Hypetensive intracerebral hemorrhage (HIH) is the most common spontaneous intracerebral hemorrhage. To determine the long-term prognosis of HIH after medical treatment 280 patients were studied. Clinical outcomes were evaluated with ability in daily life and were divided into good(ADL I-IV) or poor(V-VI) outcome. Patients with HIH were classified into basal ganglionic, thalamic, lobar, cerebellar, or pontine according to location of hematoma and into small, medium, or large according to volume of hemtoma. In each type of hematoma, the percentage of good and poor outcome were as follows; 73.3%/26.7% in basal ganglionic, 70.4%/29.6% in thalamic, 75.7%/24.3% in lobar, 58.6%/41.4% in cerebellar, and 22.7%/77.3% in pontine hematoma. Because of intraventricular extension the outcome was worse for patients with ganglionic-thalamic than for those with lobar and cerebellar hematoma in the small or medium sized hematomas. As other previous studies, the majority of subjects with deterioration of mentality, large hematoma volume, ventricular extension, or mass effect had poor outcome. Some cases with large hematoma volume and poor prognostic factors had good outcome. This study suggests that medical treatments for HIH are likely to improve the quality of life in patients with small or medium sized hematoma, even in some patients with large hematoma and other poor prognostic factors.