Helweg-Larsen S, Sommer W, Strange P, Lester J, Boysen G
Stroke. 1984 Nov-Dec;15(6):1045-8. doi: 10.1161/01.str.15.6.1045.
The long-term clinical and CT-outcome of 53 conservatively treated patients with spontaneous intracerebral hematomas (ICH) was studied in relation to the acute findings. The acute mortality of ICH was 27%. Determinant for the immediate prognosis was the level of consciousness and the volume of the hematoma. The crucial size was 50 ml with a mortality of 90% for hematomas larger and 10% for hematomas smaller than that. Intraventricular hemorrhage was a bad prognostic sign only in the ganglionic-thalamic hematomas. At follow-up at a median of 4 1/2 years after ICH, 30% of the total series had a completely normal neurological examination and 28% had resumed work. Thirteen per cent had minor neurological deficits and 17% had debilitating sequelae. During the follow-up period 7 patients had died, which indicates an excess mortality for ICH survivors. The CT findings at follow-up consisted of low density areas smaller than the original hematomas, focal atrophy, calcifications and porencephalic cysts. In 10% the CT scan revealed no trace of the previous hematoma.
对53例接受保守治疗的自发性脑出血（ICH）患者的长期临床及CT结果与急性表现进行了研究。ICH的急性死亡率为27%。即时预后的决定因素是意识水平和血肿体积。关键大小为50毫升，大于此大小的血肿死亡率为90%，小于此大小的血肿死亡率为10%。脑室出血仅在丘脑-基底节区血肿中是不良预后征象。在ICH后中位随访4.5年时，整个队列中30%的患者神经系统检查完全正常，28%的患者已恢复工作。13%的患者有轻度神经功能缺损，17%的患者有致残性后遗症。随访期间有7例患者死亡，这表明ICH幸存者存在额外死亡率。随访时的CT表现包括小于原始血肿的低密度区、局灶性萎缩、钙化和脑穿通畸形囊肿。10%的患者CT扫描显示既往血肿无痕迹。
