Shimizu Kiyoharu, Sadatomo Takashi, Hara Takeshi, Ohba Hideo, Yuki Kiyoshi, Kurisu Kaoru
Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
J Stroke Cerebrovasc Dis. 2017 Jul;26(7):1541-1546. doi: 10.1016/j.jstrokecerebrovasdis.2017.02.035. Epub 2017 Mar 8.
Chronic expanding intracerebral hematoma is a well-known complication of spontaneous intracerebral hemorrhage. However, because chronic expanding intracerebral hematoma is relatively rare, it has not been studied systemically. The purpose of this study was to characterize a patient population with chronic expanding intracerebral hematoma, and to identify the predictive factors for it.
We retrospectively evaluated 112 patients with spontaneous putaminal hemorrhage who were treated at our institution between January 1, 2010 and December 31, 2015. Data on age, sex, Glasgow Coma Scale score, presence of intraventricular hemorrhage, and intracerebral hemorrhage volume were collected, and their predictive values for chronic expanding intracerebral hematoma were investigated. We also evaluated the predictive value of a characteristic radiological finding at onset called the "layer sign," which was represented as a fluid level adjacent to the clot.
Chronic expanding intracerebral hematoma was observed in 4 patients (4.9%) with spontaneous intracerebral hemorrhage. Only the layer sign was significantly related to chronic expanding intracerebral hematoma (P = .003), and was found to be independently associated with chronic expanding intracerebral hematoma in a multivariate analysis (odds ratio, 18.6; 95% confidence interval, 1.19-291.0; P = .037).
The frequency of chronic expanding intracerebral hematoma in those with spontaneous intracerebral hemorrhage was estimated at 4.9%. The layer sign was a useful factor for predicting chronic expanding intracerebral hematoma.
慢性扩张性脑内血肿是自发性脑出血的一种已知并发症。然而，由于慢性扩张性脑内血肿相对罕见，尚未进行系统研究。本研究的目的是描述慢性扩张性脑内血肿患者群体的特征，并确定其预测因素。
我们回顾性评估了2010年1月1日至2015年12月31日在我院接受治疗的112例自发性壳核出血患者。收集了年龄、性别、格拉斯哥昏迷量表评分、脑室内出血情况和脑出血量的数据，并研究了它们对慢性扩张性脑内血肿的预测价值。我们还评估了发病时一种特征性影像学表现“分层征”的预测价值，其表现为血凝块旁的液平面。
4例（4.9%）自发性脑出血患者出现慢性扩张性脑内血肿。只有分层征与慢性扩张性脑内血肿显著相关（P = 0.003），并且在多因素分析中发现其与慢性扩张性脑内血肿独立相关（比值比，18.6；95%置信区间，1.19 - 291.0；P = 0.037）。
自发性脑出血患者中慢性扩张性脑内血肿的发生率估计为4.9%。分层征是预测慢性扩张性脑内血肿的一个有用因素。
