Correlation beteween Motor Disturbance and Involvement of the Internal Capsule in Hypertensive Intracerebral Hemorrhage

ABSTRACT

The treatment of patients with hypertensive intracerebral hemorrhage (ICH) is still controversial. Fifty-two cases with hypertensive thalamic or putaminal hemorrhage were classified into three groups on the basis of the location of the hematoma in the internal capsule on eht CT image. All the cases were confined to the anterior(Type A, 17 cases)., posterior(Type P, 25 cases) and mixed portion(Type M, 10 cases) of the posterior limb of the internal capsule, and were assigned to receive medical treatment, extraventricular drainage(EVD), or stereotactic aspiration using urokinase. This study was designed to assess the correlation between hematoma extension and the severity of motor disturbance in patients treated with stereotactic aspiration. The severity of motor weakness was found not to be related to hematoma extension, but the prognosis was frequently poor in type P and type M. The outcome was better in the stereotactic aspiration group, as compared with medical and EVD groups, especially when the hematoma was located at the posterior portion of the posterior limb of the internal capsule(p<0.05). The study suggests that stereotactic aspiration may improve the outcome of hypertensive ICH with severe motor weakness, even if the hematoma is small.