Bahrami Mahshid, Keyhanifard Majid, Afzali Mahdieh
Department of Radiology, Isfahan University of Medical Sciences Isfahan, Iran.
Iranian Board of Neurology, Tehran University of Medical Sciences Tehran, Iran.
Am J Nucl Med Mol Imaging. 2022 Jun 15;12(3):106-112. eCollection 2022.
Intracerebral hemorrhage is one of the types of stroke in patients with risk factors. In this study, we aimed to evaluate the initial computed tomography (CT) scan findings, clinical manifestations and possible risk factors of patients with intracerebral hemorrhage. This is a cross-sectional study that was performed in 2015-2022 on 900 patients with definite diagnosis of intracerebral hemorrhage. Data of patients were evaluated for patient's age, gender, clinical manifestations, primary radiologic signs in CT scan and possible risks factors for stroke. Lobar hemorrhage was the most common site of involvement (324 patients, 36%) followed by lenticular (putamen) (294 patients, 32.7%) and thalamus (135 patients, 15%). Among patients, 543 patients (60.3%) had hypertension, 81 patients (9%) had histories of anticoagulant. Hemorrhages in putamen were significantly more common in patients with hypertension (P<0.001) and lobar hemorrhages were significantly more common in patients with the use of anticoagulant drugs (P=0.033). The most common presentation of hemorrhagic stroke was decreased consciousness level (428 patients, 47.5%) followed by headache (343 patients, 38.1%), coma (81 patients, 9%) and seizure (48 patients, 5.4%). Evaluation of the relationships between patient's main symptoms and sites of involvement showed that patients with decreased consciousness as their most common symptom had more frequently diagnosed with lobar hemorrhage (54%) and putamen hemorrhage (30.4%) (P<0.001). Hypertension was the most common past medical history that was significantly related to hemorrhage in basal nuclei. Hemorrhages in putamen were common in hypertensive patients and lobar hemorrhages were common in patients with anticoagulant use.
脑出血是有风险因素患者的中风类型之一。在本研究中,我们旨在评估脑出血患者的初始计算机断层扫描(CT)扫描结果、临床表现及可能的风险因素。这是一项横断面研究,于2015年至2022年对900例确诊为脑出血的患者进行。对患者的数据进行评估,内容包括患者的年龄、性别、临床表现、CT扫描的主要影像学征象以及中风的可能风险因素。脑叶出血是最常见的受累部位(324例患者,36%),其次是豆状核(壳核)(294例患者,32.7%)和丘脑(135例患者,15%)。在患者中,543例患者(60.3%)患有高血压,81例患者(9%)有抗凝治疗史。壳核出血在高血压患者中明显更常见(P<0.001),脑叶出血在使用抗凝药物的患者中明显更常见(P=0.033)。出血性中风最常见的表现是意识水平下降(428例患者,47.5%),其次是头痛(343例患者,38.1%)、昏迷(81例患者,9%)和癫痫发作(48例患者,5.4%)。对患者主要症状与受累部位之间关系的评估表明,以意识下降为最常见症状的患者更常被诊断为脑叶出血(54%)和壳核出血(30.4%)(P<0.001)。高血压是与基底核出血显著相关的最常见既往病史。壳核出血在高血压患者中常见,脑叶出血在使用抗凝剂的患者中常见。