[Relationship between motor disturbance and involvement of internal capsule in hypertensive thalamic hemorrhage].
We treated a consecutive series of 309 patients with hypertensive thalamic hemorrhage from April 1981 to December 1987. In 99 cases of involvement of the internal capsule, the relationship between the extent of destruction of the internal capsule and motor disturbance was clinically investigated and discussed. First, these 99 cases were classified into three groups on the basis of the location of the hematoma in the internal capsule on the CT image. All the cases were confined to the anterior, middle and posterior portions of the posterior limb of the internal capsule. The correlation between hematoma extension and the severity of motor weakness, its improvement nd prognosis were discussed. The severity of motor weakness was found not to be related to hematoma extension. On the other hand, the prognosis was frequently poor when the hematoma was located at the posterior portion within the posterior limb of the internal capsule. In hypertensive thalamic hemorrhage, there seemed to be a narrow and significant area within the posterior limb of the internal capsule which determined morbidity. And, as a matter of course, the nearer the hematoma was located to the border between the middle and posterior portions, the worse the outcome was. Cases treated by aspiration surgery were evaluated to investigate the utility of aspiration surgery for thalamic hemorrhage. (Special attention was given to the ADL of those cases with severe motor weakness.) When the hematoma was located at the posterior portion of the posterior limb of the internal capsule, the percentage of patients with good outcome was significantly higher in the aspirated group than in the medical group (p less than 0.05).
Sasaki
K
K
Department of Neurological Surgery, School of Medicine, University of Tokushima.
Matsumoto
K
K
D001921:Brain / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000473:pathology; D006406:Hematoma / Q000150:complications / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology; D009069:Movement Disorders / Q000209:etiology*; D013786:Thalamic Diseases / Q000150:complications* / Q000473:pathology