[Evaluation of changes in the treatment of spontaneous intracerebral haemorrhage in a regional hospital in Mexico].
BACKGROUND
The spontaneous intracerebral hemorrhage (ICH) shows a high lethal rate. In 1999 appeared the first therapeutic guidelines, after that new therapies have been assessed without substantial success.


OBJECTIVE
To describe treatment changes for ICH in a regional Mexican hospital and to assess their impact on clinical evolution.


METHODS
We accomplished a retrospective study of patients admitted between 2000 and 2006. We included those elder than 15 years with tomographyc diagnostic of ICH. Patients with head injury four weeks before or undetermined initial National Institute of Health Stroke Scale (NIHSS) were excluded. Epidemiological, clinical characteristics and kind of therapy were studied.


RESULTS
We analyzed 175 patients with mean age of 62 years. Etiology and localization more frequently were arterial hypertension and lobar, respectively. More than 20% were intubated and approximately one half of these admitted in intensive care unit. Angiotensin converter enzyme inhibitors were the medicaments more usually used for controlling blood pressure. An initial NIHSS > 15 or Glasgow < 9 were associated to poor outcome. Additional administration of calcium antagonist, statins and surgical decompression was associated to a better outcome.


CONCLUSIONS
Use of intensive care units is a measure highly suggested as standard for ICH-therapy. In our center it was not regularly accomplished because of infrastructural deficiencies. This problem could be generated in other Mexican hospitals; attention to that phenomenon is urgently required. Evaluation of new therapeutic strategies is required.
Tapia-Pérez
Humberto
H
Universidad Autonoma de San Luis Potosi, San Luis de Potosi, Mexico. lehwand@hotmail.com
González-Aguirre
Daniel
D
Sánchez-Aguilar
Martín
M
Torres-Corzo
Jaime
J
Rodríguez-Leyva
Ildefonso
I
Gordillo-Moscoso
Antonio
A
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006973:Hypertension / Q000628:therapy; D007362:Intensive Care Units; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents