title: Subarachnoid hemorrhage and intracerebral hematoma caused by aneurysms of the anterior circulation: influence of hematoma localization on outcome.
abstract: Additional space-occupying intracerebral hematoma (ICH) in patients suffering from subarachnoid hemorrhage (SAH) is a known predictor for poor outcome. Emergent clot evacuation might be mandatory. However, data concerning the influence of ICH location on outcome is scarce. Therefore, we analyzed the influence of ICH location on clinical course and outcome in patients with SAH and additional ICH. One hundred seventy-four patients were treated with aneurysmal SAH and additional ICH between September 1999 and May 2012. Information including patient characteristics, treatment, and radiological findings were prospectively entered into a database. Patients were stratified according to ICH location and neurological outcome. Neurological outcome was assessed according to modified Rankin Scale (mRS). ICH location was temporal (58.6 %), frontal (28.7 %), and perisylvian ICH (12.6 %); 63.8 % presented in poor admission status and favorable outcome was achieved in 35.6 %. In the multivariate analysis, favorable outcome was associated with young age, ICH <50 ml, and good admission status. The location of ICH was not associated with outcome. The current data confirms that a significant number of patients with ICH after aneurysm rupture achieve favorable outcome. Prognostic factor for favorable outcome are "age," "size of the hematoma," and "admission status." The location of the ICH seems not to be associated with outcome.
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany, markus.bruder@kgu.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Bruder
authors.forename: Patrick
authors.initials: P
authors.lastname: Schuss
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
authors.forename: Marlies
authors.initials: M
authors.lastname: Wagner
authors.forename: Hartmut
authors.initials: H
authors.lastname: Vatter
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.forename: Erdem
authors.initials: E
authors.lastname: Güresir
mesh_terms: D000328:Adult; D000368:Aged; D056424:Decompressive Craniectomy / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006406:Hematoma / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000473:pathology / Q000601:surgery; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome