title: Prognostic factors in patients with primary brainstem hemorrhage.
abstract: OBJECTIVE
  Primary brainstem hemorrhage (PBH) frequently causes severe disturbances of consciousness, papillary abnormalities, as well as respiratory and motor disturbances. The prognosis has been reported to be highly dependent on the clinical severity at presentation and the presence of certain radiological markers. However, the number of PBH patients enrolled in previous reports tended to be small, and precise statistical analyses were also lacking. The aim of this study was to analyze the impact of clinical or radiologic parameters on the outcome of patients with PBH.
  
  
  METHODS
  We retrospectively reviewed 212 consecutive patients with PBH and analyzed the impact of the clinical or radiological parameters on the outcome of patients with PBH.
  
  
  RESULTS
  Of the 212 patients, 134 (63.2%) were male and 78 (36.8%) were female, with an age range of 17-97 years (mean, 60.3 years). The median admission GCS score was 4. The outcomes included a good recovery in 13 patients (6.1%), moderate disability in 27 (12.7%), severe disability in 27 (12.7%), a vegetative state in 23 (10.8%), and death in 122 (57.5%). A multivariate analysis demonstrated bilateral hematoma extension, a GCS score ≤8, the presence of hydrocephalus, gender, and the hematoma volume to all be significantly associated with the 3-month mortality, while the GCS score ≤8, the presence of a pupillary abnormality, and the hematoma volume were found to be associated with the 3-month poor outcome.
  
  
  CONCLUSIONS
  The identification of these factors is therefore considered to be useful for managing patients with PBH.
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Go
authors.initials: G
authors.lastname: Suzuki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takasato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masaoka
authors.forename: Takanori
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsushige
authors.forename: Keigo
authors.initials: K
authors.lastname: Shigeta
authors.forename: Toshiya
authors.initials: T
authors.lastname: Momose
authors.forename: Kojiro
authors.initials: K
authors.lastname: Wada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nawashiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers; D001933:Brain Stem; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D006973:Hypertension / Q000150:complications; D020300:Intracranial Hemorrhages / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011680:Pupil; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers