Brott T, Broderick J, Kothari R, Barsan W, Tomsick T, Sauerbeck L, Spilker J, Duldner J, Khoury J
University of Cincinnati Medical Center, Department of Neurology, OH 45267-0525, USA.
Stroke. 1997 Jan;28(1):1-5. doi: 10.1161/01.str.28.1.1.
The goal of the present study was to prospectively determine how frequently early growth of intracerebral hemorrhage occurs and whether this early growth is related to early neurological deterioration.
We performed a prospective observational study of patients with intracerebral hemorrhage within 3 hours of onset. Patients had a neurological evaluation and CT scan performed at baseline, 1 hour after baseline, and 20 hours after baseline.
Substantial growth in the volume of parenchymal hemorrhage occurred in 26% of the 103 study patients between the baseline and 1-hour CT scans. An additional 12% of patients had substantial growth between the 1- and 20-hour CT scans. Hemorrhage growth between the baseline and 1-hour CT scans was significantly associated with clinical deterioration, as measured by the change between the baseline and 1-hour Glasgow Coma Scale and National Institutes of Health Stroke Scale scores. No baseline clinical or CT prediction of hemorrhage growth was identified.
Substantial early hemorrhage growth in patients with intracerebral hemorrhage is common and is associated with neurological deterioration. Randomized treatment trials are needed to determine whether this early natural history of ongoing bleeding and frequent neurological deterioration can be improved.
本研究的目的是前瞻性地确定脑出血早期增长的频率，以及这种早期增长是否与早期神经功能恶化有关。
我们对发病3小时内的脑出血患者进行了一项前瞻性观察研究。患者在基线时、基线后1小时和基线后20小时进行了神经学评估和CT扫描。
在103例研究患者中，26%的患者在基线CT扫描和1小时CT扫描之间实质性脑实质出血体积增大。另外12%的患者在1小时CT扫描和20小时CT扫描之间有实质性增长。基线CT扫描和1小时CT扫描之间的出血增长与临床恶化显著相关，临床恶化通过基线和1小时格拉斯哥昏迷量表以及美国国立卫生研究院卒中量表评分之间的变化来衡量。未发现出血增长的基线临床或CT预测因素。
脑出血患者早期出血大量增长很常见，且与神经功能恶化有关。需要进行随机治疗试验，以确定这种持续出血和频繁神经功能恶化的早期自然病程是否可以改善。
