Türk Beyin Damar Hast Derg. 2006; 12(2): 53-58

SPONTANEOUS ÝNTRACEREBRAL HEMORRHAGES: THE EVOLUATÝON OF 459HEMATOMA WÝTH THEÝR CT SCAN, PROGNOSÝS, MORTALÝTY

Zahide YILMAZ¹, Nihal IÞIK², Ramazan KAVAL³, Ýlknur AYDIN², Fatma CANDAN², Sebatiye ERDOÐAN⁴, Taner SELEKER^2
1
2
3
4

459 patients in our clinic with the diagnosis of intracerebral hemorrhage, were evaluated retrospectively for age, sex, risk factors, the conscious degree, hematoma localization, size, mid-line shift and rupture of the hematoma into the ventricule; also these factors were examined for their effects on the mortality. The percentage of HT was 83.7%. The localization of the hemorrhage was the most frequently putaminal (37.9%). Lober (23.3%), thalamic (22.4%), cerebellar (9.2%), brainstem (5.9%) and caudat (1.3%) were the following ones. The mortality rate of the patients was 44.9%. It has been established that the baseline conscious degree at the patients acceptance to the hospital, the localization of the hemorrhage, size, mid-line shift and rupture into the ventricule had no effects on outcomes. The mean Glascow Coma Scale was 13 in the survival patients and it was 6.4 in the exitus patients. The outcomes were the best in thalamic localization (the percentage of the mortality: 33%), and the worst in brainstem localization (the percentage of the mortality: 6.3%). In general, in all of the localizations, the mortality was rising with the increase of the diameter of the hemorrhage. At the hematomas with a diameter of under 1 cm, the mortality rate was decreasing to 2.6% while, it was increasing to 93.3% at the hematomas with a diameter of bigger than 8 cm.

Keywords: Ýntracerebral hemorraghe-Computerized tomography-Prognosis-Mortality-Disturbance of conciousness

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SPONTAN ÝNTRASEREBRAL KANAMALAR: 459 VAKANIN BT BULGULARI, PROGNOZ VE MORTALÝTE AÇISINDAN DEÐERLENDÝRÝLMESÝ

Zahide YILMAZ¹, Nihal IÞIK², Ramazan KAVAL³, Ýlknur AYDIN², Fatma CANDAN², Sebatiye ERDOÐAN⁴, Taner SELEKER^2
1Kütahya Evliya Çelebi Devlet Hastanesi
²Ýstanbul Göztepe Eðitim ve Araþtýrma Hastanesi
³Merzifon Devlet Hastanesi
⁴Kastamonu Þerife Bacý Devlet Hastanesi

Kliniðimizde spontan intraserebral kanama tanýsýyla takip edilen 459 vaka; yaþ, cins, risk faktörleri, bilinç düzeyi, kanamanýn yerleþimi, boyutu, orta hat þifti ve kanamanýn ventriküle açýlýmý açýsýndan retrospektif olarak gözden geçirilerek, bu faktörlerin mortalite üzerine etkileri araþtýrýldý. Hipertansiyon sýklýðý %83.7 olarak bulundu. Kanama, en sýk putaminal (%37.9), lobar (%23.3), talamik (%22.4), serebellar (%9.2), beyin sapý (%5.9) ve kaudat (%1.3) yerleþimli olarak bulundu. Olgularýn mortalite oraný %44.9 olarak saptandý. Hastanýn baþvuru sýrasýndaki bilinç durumu, kanamanýn lokalizasyonu, boyutu, orta hat þifti, ventriküle açýlým varlýðýnýn prognozu etkilediði tespit edildi. Yaþayan olgularýn ortalama Glaskow Koma Skalasý 13, kaybedilen olgularýn ise 6.4 olarak saptandý. Talamik yerleþimli kanamalarýn prognozu en iyi (mortalite oraný %33), beyin sapý yerleþimli kanamalarýnýn prognozu ise en kötüydü (%63). Genel olarak tüm lokalizasyonlarda çap arttýkça mortalite oraný artmaktaydý. Mortalite oranýnýn, 1 cm den küçük kanamalarda %2.6 ya kadar düþmesine raðmen, 8 cm den büyük kanamalarda %93.3 e kadar çýktýðý tespit edildi.

Anahtar Kelimeler: Ýntraserebral kanama-Bilgisayarlý tomografi-Prognoz-Mortalite- Bilinç bozukluðu

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