[Cerebral hemorrhage in Taiwan].
Stroke was the leading cause of death in Taiwan for 19 years (1963-1981). About 60% of the hospitalized patients dying of stroke suffered from cerebral hemorrhage (CH). This fact denotes an important role of CH in causing fatal stroke. The widely use of computed tomography (CT) in Taiwan in the past decade enables clear differentiation between CH and cerebral infarction (CI). In Taiwan, the ratio of CH: CI is 1:1.5, which is 3.5 times higher than that of the Western countries. CH is most prevalent between aged 55 and 65 years; the male to female ratio after adjusted to that of general population is around 1.1:1. Hypertension is the most important risk factor (86.7%) and spontaneous CH is, therefore, often referred to as "hypertensive CH". CH has a predilection to occur in the putamen (41%), thalamus (23%), putaminothalamus (9.7%), subcortical white mater (9.3%), brainstem (6.5%), and cerebellum (5.9%). Motor dysfunction (80%) is the most frequent clinical manifestation, followed by disturbance of consciousness (50%), and language problems (31.1%). In addition to motor and consciousness disturbance, vomiting (30.8%) and headache (27%) are among important initial presentations, especially for cerebellar and intraventricular hemorrhage. For patients with stable condition after CH, medical treatment is the mainstay of therapy. If condition deteriorates during medical treatment, surgical intervention may be considered for patients with cerebellar, lobar, or putaminal hemorrhage. In Taiwan, 11.6% of patients with CH receive surgical treatment. The mortality rate one month after CH was 53.7% before the CT era; it has decreased to 23.3% in recent years.(ABSTRACT TRUNCATED AT 250 WORDS)
Hung
T P
TP
Department of Neurology, National Taiwan University Hospital, Taipei.
Chen
S T
ST
D000328:Adult; D000367:Age Factors; D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology