Clinical Analysis of the Factors Affecting the Growth or Rebleeding of Spontaneous Intracerebral Hemorrhages

Kim, Do Heon; Moon, Jae Gon; Hwang, Yong Soon; Kim, Han Kyu; Yoo, Chung Sun; Lee, Hwa Dong

Abstract

The growth or rebleeding of the spontaneous ICH is catastrophic so that prevention of them is critical in management. We reviewed 233 cases of spontaneous ICH from Jan. 1990 to Dec. 1994 to evaluate the factors associated with the hematoma enlargement. The relationship among the admission time from hematoma onset, the systolic BP at admission, hemostatic parameter, liver dysfunction with rebleeding incidence were assessed. Also, hematoma shape, density, site, volume, and operation tiem from hematoma onset were evaluated. Hematoma growth was oserved at 26 patients(11.6%). Incidence of rebleeding was significantly associated in patients with shorter admission time from hematoma onset, high systoic BP at admission, inhomogenous, irregular-shaped hematoma at CT and liver dysfunction. The incidence of hematoma growth was higher in the early operation group but there was no significant relationship in statistic analysis. Patients admitted within 6 hours of hematoma onset, with irregular-shaped, inhomogenous hematoma on CT, and liver dysfunction should be observed closely for the enlargement of hematoma. The operation time might be delayed at least 6 hours after hematoma onset.