[Prognosis and classification of hypertensive striatocapsular haemorrhages].
BACKGROUND
Nontraumatic intracerebral haemorrhage accounts for 10 to 15% of all cases of stroke.


METHODS
In our study hypertensive striatocapsular haemorrhages were divided into six types on the basis of arterial territories: posterolateral, lateral, posteromedial, middle, anterior and massive (where the origin of the hemorrhage can not be defined due to the extensive damage of the striatocapsular region) type. We analysed laboratory data, clinical presentations and risk factors as alcoholism, smoking and hypertension of 111 cases. The size of the hematoma, midline shift and severity of ventricular propagation were measured on the acute CT-scan. The effect on the 30-day clinical outcome of these parameters were examined.


CONCLUSIONS
According to our results, the most important risk factor of hypertensive intracerebral haemorrhage was chronic alcoholism. Blood cholesterol, triglyceride levels and coagulation status had no effect on the prognosis, but high blood glucose levels significantly worsen the clinical outcome. In our study, lateral striatocapsular haemorrhage was the most common while middle one was the least common type. The overall mortality is 42%, but differs by the type. The 30-day outcome significantly depends on the type of the haemorrhage, the initial level of consciousness, the size of the haematoma, the severity of ventricular propagation, the midline shift and the blood glucose levels. The clinical outcome proved to be the best in the anterior type, good in the posteromedial and lateral types. The prognosis of the massive type is poor. In our study, the classes and the mortality of the striatocapsular haemorrhages was different from the literature data. The higher mortality in our cohort could be due to the longer follow-up and the severe accompanying diseases of our patients.
Semmelweis Egyetem, Altalános Orvostudományi Kar, Neurológiai Klinika, Budapest.
Csilla
C
Hornyák
Tibor
T
Kovács
Péter
P
Pajor
Imre
I
Szirmai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003342:Corpus Striatum / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000145:classification* / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol