[Fundus hemorrhage in patients with intracranial hemorrhage caused by cerebrovascular disease--its clinical significance].
To clarify the significance of fundus hemorrhage in the acute stage of intracranial hemorrhage due to cerebrovascular disease (HCVD), the incidence of such hemorrhage (retinal, preretinal, and subhyaloid hemorrhage) was examined and its correlations with the severity of the disturbance of consciousness and the prognosis were investigated. Two hundred sixteen HCVD patients with intracranial hemorrhage were the subjects of this study, including 87 cases of subarachnoid hemorrhage (SAH), 60 cases of hypertensive intracerebral hemorrhage (HICH), 54 cases of arteriovenous malformation (AVM), and 15 cases of Moyamoya disease. Fundus hemorrhage was recognized in 41 cases of SAH (47%), 5 cases of HICH (8%), 3 cases of AVM (6%), and 2 cases of Moyamoya disease (13%). The incidence of fundus hemorrhage was significantly higher in SAH than in the other type of HCVD associated with intracranial hemorrhage. Among patients with severe disturbance of consciousness (JCS 100-300), fundus hemorrhage was recognized in 69% with SAH, 13% with HICH, 17% with AVM, and none with Moyamoya disease. Therefore, patients with both fundus hemorrhage and severe disturbance of consciousness in the acute stage are most likely to have SAH, but HICH and AVM should be also taken into consideration. In patients with slight disturbance of consciousness (JCS 0-30), fundus hemorrhage was only noted in SAH (27%) and not in other types of HCVD associated with intracranial hemorrhage. Thus, SAH is highly likely to be the primary HCVD associated with intracranial hemorrhage, if we recognize fundus hemorrhage in patients with slight disturbance of consciousness in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)
Takano
S
S
Department of Neurosurgery, Kitasato University, Sagamihara, Japan.
Saito
M
M
Miyasaka
Y
Y
Yada
K
K
Kitahara
T
T
Ohwada
T
T
Takagi
H
H
D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D002561:Cerebrovascular Disorders / Q000150:complications*; D005654:Fundus Oculi; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications; D007564:Japan / Q000453:epidemiology; D009072:Moyamoya Disease / Q000150:complications; D012166:Retinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000209:etiology