一项针对57例小脑出血患者的新的简单测量方法与预后相关。回顾性分析结果。
A novel simple measure correlates to the outcome in 57 patients with intracerebellar hematomas. Results of a retrospective analysis.
作者信息
Doukas Alexandros, Maslehaty Homajoun, Barth Harald, Hedderich Jürgen, Petridis Athanasios K, Mehdorn H Maximilian
机构信息
Department of Neurosurgery, University Clinics Schleswig-Holstein, Campus Kiel, Germany.
Department of Neurosurgery, University Clinic Essen, Campus Kiel, Germany.
出版信息
Surg Neurol Int. 2015 Nov 23;6:176. doi: 10.4103/2152-7806.170246. eCollection 2015.
BACKGROUND
The incidence of intracerebellar hemorrhages approaches 5-10% of all intracerebral hematomas. The clinical presentation varies from headaches and dizziness to rapid deterioration of consciousness to the point of coma in severe cases. In order to find some concrete criteria that could influence the prognosis of these patients, we performed this retrospective study.
METHODS
We retrospectively analyzed the factors influencing the outcome of 57 patients with intracerebellar hematomas treated in our clinic in the last 7 years. The Glasgow Coma Scale (GCS) on admission, as well as other parameters as hypertension, diabetes mellitus, presence of malign tumors in the medical history, or the intake of anticoagulants were assessed as independent factors influencing the outcome of the patients. On the other hand, various computed tomography parameters on admission were also correlated with the clinical outcome such as, tight posterior fossa (TPF), volume of the hematoma, hydrocephalus, compression of the fourth ventricle, intraventricular bleeding, as well as the ratio of the maximal width of the hematoma in comparison to the width of the PF were taken into consideration.
RESULTS
The results of the study showed that patients with poor GCS on admission had also a poor Glasgow Outcome Score. Interestingly there was a statistically significant correlation between the maximal width of the hematoma in comparison to the width of the PF and the outcome of the patients. It could be also shown that the patients with intraventricular hemorrhage, hydrocephalus, compression of the fourth ventricle over 50% of its maximal width and TPF, had a poor clinical outcome. Moreover, there was a statistically significant correlation of the volume of the hematoma and a poor clinical outcome.
CONCLUSIONS
We introduced as a new factor that is, the cerebellar hemorrhage/PF ratio and found out that the value >35% was associated to an unfavorable outcome.
背景
小脑内出血的发生率约占所有脑内血肿的5%-10%。临床表现从头痛、头晕到意识迅速恶化，严重时可发展至昏迷。为了找到一些能够影响这些患者预后的具体标准，我们进行了这项回顾性研究。
方法
我们回顾性分析了过去7年在我院接受治疗的57例小脑内血肿患者的预后影响因素。将入院时的格拉斯哥昏迷量表（GCS）以及其他参数，如高血压、糖尿病、病史中是否存在恶性肿瘤或是否服用抗凝剂等作为影响患者预后的独立因素进行评估。另一方面，入院时的各种计算机断层扫描参数也与临床结局相关，如后颅窝狭窄（TPF）、血肿体积、脑积水、第四脑室受压、脑室内出血，以及血肿最大宽度与后颅窝宽度的比值等。
结果
研究结果表明，入院时GCS评分低的患者格拉斯哥预后评分也低。有趣的是，血肿最大宽度与后颅窝宽度的比值与患者的预后之间存在统计学上的显著相关性。还可以表明，发生脑室内出血、脑积水、第四脑室受压超过其最大宽度的50%以及TPF的患者临床结局较差。此外，血肿体积与不良临床结局之间存在统计学上的显著相关性。
结论
我们引入了一个新的因素，即小脑出血/后颅窝比值，发现该值>35%与不良预后相关。
Zotero 插件