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高血压性丘脑出血:短期预后分析

Hypertensive thalamic hemorrhage: analysis of short-term outcome.

作者信息

Ruiz-Sandoval José L, Chiquete Erwin, Parra-Romero Gustavo, Carrillo-Loza Karina, Parada-Garza Juan D, Pérez-Gómez Héctor R, Ochoa-Plascencia Miguel R, Aguirre-Portillo Leonardo

机构信息

a Department of Neurology , Hospital Civil de Guadalajara 'Fray Antonio Alcalde' , Guadalajara , Jalisco , México.

b Traslational Neurociences Institute, Department of Neurosciences , Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara , Guadalajara , Jalisco , Mexico.

出版信息

Int J Neurosci. 2019 Feb;129(2):189-194. doi: 10.1080/00207454.2018.1518905. Epub 2018 Oct 31.

Abstract

BACKGROUND

Hypertension is the main cause of intracerebral hemorrhage with a thalamic location frequency that varies from 6% to 26.5%.

OBJECTIVE

We aimed to identify clinical and radiological features that could impact the short-term prognosis in patients with hypertensive thalamic hemorrhage (HTH).

METHODS

Consecutive patients presenting to a tertiary referral hospital with HTH were analyzed from 2010 to 2014. Clinical features at emergency department and a 30-day outcome using the modified Rankin Scale (mRS) were obtained.

RESULTS

A total of 104 patients were studied (53 women, mean age 68.2 years, range 27-91 years), 91 (87.5%) of them with hypertension history. Mean hemorrhage volume was 12.2 mL (range 2-45 mL), without significant differences according to gender or age group. Irruption into the ventricular system occurred in 79 (76%) cases. Thirty-day mortality was 38.5% and occurred with a higher frequency in men, in patients with GCS <8, intraventricular irruption, ventriculostomy, and intracerebral hemorrhage volumes >15 mL.

CONCLUSIONS

Although HTH is associated with relatively small hemorrhage volume, it had a higher frequency of ventricular irruption and bad prognosis at short-term.

摘要

背景

高血压是脑出血的主要原因,丘脑部位脑出血的发生率在6%至26.5%之间。

目的

我们旨在确定可能影响高血压性丘脑脑出血(HTH)患者短期预后的临床和影像学特征。

方法

对2010年至2014年在一家三级转诊医院就诊的连续HTH患者进行分析。获取急诊科的临床特征以及使用改良Rankin量表(mRS)评估的30天预后情况。

结果

共研究了104例患者(53例女性,平均年龄68.2岁,范围27 - 91岁),其中91例(87.5%)有高血压病史。平均出血量为12.2毫升(范围2 - 45毫升),按性别或年龄组无显著差异。79例(76%)患者出现破入脑室系统的情况。30天死亡率为38.5%,男性、格拉斯哥昏迷量表(GCS)评分<8分、脑室出血、脑室造瘘以及脑出血量>15毫升的患者死亡率更高。

结论

尽管HTH的出血量相对较小,但脑室出血的发生率较高,且短期预后较差。

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