Ruiz-Sandoval José L, Chiquete Erwin, Gárate-Carrillo Alejandra, Ochoa-Guzmán Ana, Arauz Antonio, León-Jiménez Carolina, Carrillo-Loza Karina, Murillo-Bonilla Luis M, Villarreal-Careaga Jorge, Barinagarrementería Fernando, Cantú-Brito Carlos
Neurology and Neurosurgery Department, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, México.
Rev Neurol. 2011 Dec 16;53(12):705-12.
Scarce information exists on intracerebral hemorrhage (ICH) in Latin America, and the existent is derived from single-center registries with non-generalizable conclusions. The aim of this study is to describe the frequency, etiology, management and outcome of ICH in Mexico.
We studied consecutive patients with ICH pertaining to the National Multicenter Registry on Cerebro-vascular Disease (RENAMEVASC), conducted in 25 centers from 14 states of Mexico. The Intracerebral Hemorrhage Grading Scale (ICH-GS) at admission was used to assess prognosis at 30 days follow-up.
Of 2,000 patients with acute cerebrovascular disease registered in RENAMEVASC, 564 (28%) had primary ICH (53% women; median age: 63 years; interquartile range: 50-75 years). Hypertension (70%), vascular malformations (7%) and amyloid angiopathy (4%) were the main etiologies. In 10% of cases etiology could not be determined. Main ICH locations were basal ganglia (50%), lobar (35%) and cerebellum (5%). Irruption into the ventricular system occurred in 43%. Median score of ICH-GS was 8 points: 49% had 5-7 points, 37% had 8-10 points and 15% had 11-13 points. The 30-day case fatality rate was 30%, and 31% presented severe disability. The 30-day survival was 92% for patients with ICH-GS 5-7 points, whereas it decreased to 27% in patients with ICH-GS 11-13 points.
In Mexico, ICH represents about a third of the forms of acute cerebrovascular disease, and the majority of patients present severe disability or death at 30 days of follow-up. Hypertension is the main cause; hence, control of this important cardiovascular risk factor should reduce the health burden of ICH.
拉丁美洲关于脑出血（ICH）的信息稀缺，现有信息来自单中心登记处，其结论无法推广。本研究的目的是描述墨西哥脑出血的发病率、病因、治疗及预后。
我们研究了墨西哥14个州25个中心进行的全国脑血管疾病多中心登记处（RENAMEVASC）中连续的脑出血患者。入院时采用脑出血分级量表（ICH-GS）评估30天随访时的预后。
在RENAMEVASC登记的2000例急性脑血管疾病患者中，564例（28%）为原发性脑出血（女性占53%；中位年龄：63岁；四分位间距：50-75岁）。高血压（70%）、血管畸形（7%）和淀粉样血管病（4%）是主要病因。10%的病例病因无法确定。脑出血的主要部位是基底节（50%）、脑叶（35%）和小脑（5%）。43%的患者出血破入脑室系统。ICH-GS的中位评分为8分：49%的患者评分为5-7分，37%的患者评分为8-10分，15%的患者评分为11-13分。30天病死率为30%，31%的患者出现严重残疾。ICH-GS评分为5-7分的患者30天生存率为92%，而ICH-GS评分为11-13分的患者30天生存率降至27%。
在墨西哥，脑出血约占急性脑血管疾病形式的三分之一，大多数患者在随访30天时出现严重残疾或死亡。高血压是主要原因；因此，控制这一重要的心血管危险因素应可减轻脑出血的健康负担。
