[Evaluation of the hypertensive intracerebral hematoma based on the study on long-term outcome--Part I. Mode of hematoma extension and its clinical significance in putaminal hemorrhage].
A retrospective analysis of our series of 355 cases of putaminal hemorrhage revealed some interesting aspects of its pathogenesis. All the cases were studied in detail with special attention to clinical presentation, diagnostic findings and the long-term clinical outcome. Role of surgery in management of putaminal hemorrhage is still controversial. Inability to form proper useful classification has been one of the reasons responsible for this controversy. A new classification is formulated which divides putaminal hemorrhage into four types. Mild type has hematoma localized to external capsule while moderate type shows hematoma extension to corona radiata from external capsule. In severe type, hematoma extends to internal capsule also while in very severe type it further extends to midbrain. These four types could be very well correlated to long-term clinical outcome. Accessory hematoma is discussed in detail. It is found to be more common in severe and very severe types. Its presence in mild or moderate types results in worse clinical outcome. Hypertension (BP greater than 200 mm of Hg) may play an important role in further extension of hematoma.
D002543:Cerebral Hemorrhage / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D005500:Follow-Up Studies; D006406:Hematoma / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D002532:Intracranial Aneurysm / Q000150:complications; D011699:Putamen / Q000098:blood supply*; D012189:Retrospective Studies