Suthar Nilay N, Patel Khushali L, Saparia Chirag, Parikh Ami P
Department of Internal Medicine, Sheth V.S. General Hospital and Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.
Ann Afr Med. 2016 Apr-Jun;15(2):69-77. doi: 10.4103/1596-3519.176259.
Incidence of intracerebral hemorrhage (ICH) is twice as high as in Western countries. Prognostic factors for predicting function outcome and mortality play a major role in determining the treatment outcome.
A prospective study of male and female patients ≥12 years with primary nontraumatic intracranial hemorrhage were included. Hemorrhage caused by trauma, anticoagulant or thrombolytic drugs, brain tumor, saccular arterial aneurysm or vascular malformation were excluded. Functional outcome of patients was determined by modified Rankin's scale. Glasgow Coma Scale (GCS) score and ICH score were calculated for each patient.
Hypertension was present in 45 out of 49 patients (92%) with ICH of basal ganglia. Hypertension was significantly associated with worst clinical outcome. Mortality was high if the patient was comatose/stuporous compared to drowsy state (P < 0.0001). Mortality was found to be high when the size exceeded 30 cm3. High ICH score, low GCS score at the time of admission, presence of intraventricular hemorrhage, and midline shift were significantly associated with poor clinical outcome.
Intracranial hemorrhage can be deleterious if present with low GCS score, high ICH score, intraventricular extension, and midline shift.
脑出血（ICH）的发病率是西方国家的两倍。预测功能结局和死亡率的预后因素在决定治疗结果中起主要作用。
纳入年龄≥12岁的原发性非创伤性颅内出血的男性和女性患者进行前瞻性研究。排除由创伤、抗凝或溶栓药物、脑肿瘤、囊状动脉瘤或血管畸形引起的出血。患者的功能结局由改良Rankin量表确定。为每位患者计算格拉斯哥昏迷量表（GCS）评分和ICH评分。
49例基底节区脑出血患者中有45例（92%）存在高血压。高血压与最差的临床结局显著相关。与嗜睡状态相比，昏迷/昏睡患者的死亡率较高（P < 0.0001）。当出血量超过30 cm³时，死亡率较高。高ICH评分、入院时低GCS评分、脑室内出血的存在和中线移位与不良临床结局显著相关。
如果存在低GCS评分、高ICH评分、脑室内扩展和中线移位，颅内出血可能是有害的。
