Thalamic haemorrhage vs internal capsule-basal ganglia haemorrhage: clinical profile and predictors of in-hospital mortality.
BACKGROUND
There is a paucity of clinical studies focused specifically on intracerebral haemorrhages of subcortical topography, a subject matter of interest to clinicians involved in stroke management. This single centre, retrospective study was conducted with the following objectives: a) to describe the aetiological, clinical and prognostic characteristics of patients with thalamic haemorrhage as compared with that of patients with internal capsule-basal ganglia haemorrhage, and b) to identify predictors of in-hospital mortality in patients with thalamic haemorrhage.


METHODS
Forty-seven patients with thalamic haemorrhage were included in the "Sagrat Cor Hospital of Barcelona Stroke Registry" during a period of 17 years. Data from stroke patients are entered in the stroke registry following a standardized protocol with 161 items regarding demographics, risk factors, clinical features, laboratory and neuroimaging data, complications and outcome. The region of the intracranial haemorrhage was identified on computerized tomographic (CT) scans and/or magnetic resonance imaging (MRI) of the brain.


RESULTS
Thalamic haemorrhage accounted for 1.4% of all cases of stroke (n = 3420) and 13% of intracerebral haemorrhage (n = 364). Hypertension (53.2%), vascular malformations (6.4%), haematological conditions (4.3%) and anticoagulation (2.1%) were the main causes of thalamic haemorrhage. In-hospital mortality was 19% (n = 9). Sensory deficit, speech disturbances and lacunar syndrome were significantly associated with thalamic haemorrhage, whereas altered consciousness (odds ratio [OR] = 39.56), intraventricular involvement (OR = 24.74) and age (OR = 1.23), were independent predictors of in-hospital mortality.


CONCLUSIONS
One in 8 patients with acute intracerebral haemorrhage had a thalamic hematoma. Altered consciousness, intraventricular extension of the hematoma and advanced age were determinants of a poor early outcome.
Arboix
Adrià
A
Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain. aarboix@hscor.com
Rodríguez-Aguilar
Raquel
R
Oliveres
Montserrat
M
Comes
Emili
E
García-Eroles
Luis
L
Massons
Joan
J
D000368:Aged; D000369:Aged, 80 and over; D020145:Basal Ganglia Hemorrhage / Q000453:epidemiology / Q000401:mortality*; D016009:Chi-Square Distribution; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D020772:Internal Capsule / Q000473:pathology*; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013788:Thalamus / Q000473:pathology*