title: Factors affecting outcome of intracerebral hemorrhage in patients undergoing chronic hemodialysis.
abstract: To date, despite a markedly high incidence of intracerebral hemorrhage (ICH) in patients with end-stage renal disease, only few studies have focused on factors that affect patient's prognosis. To elucidate these factors, we retrospectively investigated 22 consecutive patients who had chronic renal failure, were maintained by hemodialysis (HD), had suffered from ICH, and were hospitalized and treated in our institute from 2006 to 2008. Hematoma volume, blood pressure on admission, blood pressure 3 days after ICH onset, and neurological deterioration significantly affected patient mortality. Progression of neurological symptoms during HD was observed often in patients with hematoma of more than 60 mL or in patients with pontine hemorrhages. Age, gender, duration of HD, anti-platelet or anticoagulant therapies, or maximal dose of nicardipine did not affect patient's prognosis. Based on this study we conclude that controlling blood pressure on admission and within 3 days after onset of ICH may be the most important factor that would improve patient's prognosis. Further, special care might be required for patients with large hematomas (more than 60 mL) or those with brainstem hemorrhages, because progression of neurological symptoms occurs often in such patients.
authors: Department of Neurosurgery, Miyazaki Prefectural Hospital, Kitatakamatsu-cho, Miyazaki, Japan. hochiai@fc.miyazaki-u.ac.jp
authors: Hidenobu
authors: H
authors: Ochiai
authors: Shigehiro
authors: S
authors: Uezono
authors: Hirokazu
authors: H
authors: Kawano
authors: Naoko
authors: N
authors: Ikeda
authors: Keiko
authors: K
authors: Kodama
authors: Hiroshi
authors: H
authors: Akiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors