Journal of Korean Neurosurgical Society
- 제30권2호
- /
- Pages.207-210
- /
- 2001
- /
- 2005-3711(pISSN)
- /
- 1598-7876(eISSN)
초기상태가 불량한 자발성 뇌출혈 환자의 예후 - 70세 이상의 고령환자를 대상으로 -
The Prognosis of Spontaneous Intracerebral Hemorrhage in over the Seventies with Poor Initial Conditions
- 김주한 (고려대학교 의과대학 신경외과학교실) ;
- 이자규 (성남 중앙병원 신경외과) ;
- 임동준 (고려대학교 의과대학 신경외과학교실) ;
-
권택현
(고려대학교 의과대학 신경외과학교실) ;
- 박정율 (고려대학교 의과대학 신경외과학교실) ;
-
정흥섭
(고려대학교 의과대학 신경외과학교실) ;
- 이훈갑 (고려대학교 의과대학 신경외과학교실) ;
- 서중근 (고려대학교 의과대학 신경외과학교실)
- Kim, Joo Han (Department of Neurosurgery, College of Medicine, Korea University) ;
- Lee, Ja Kyu (Department of Neurosurgery, Sungnam Chungang Hospital) ;
- Lim, Dong Jun (Department of Neurosurgery, College of Medicine, Korea University) ;
-
Kwon, Tack Hyun
(Department of Neurosurgery, College of Medicine, Korea University) ;
- Park, Jung Yul (Department of Neurosurgery, College of Medicine, Korea University) ;
-
Chung, Hung Seob
(Department of Neurosurgery, College of Medicine, Korea University) ;
- Lee, Hoon-Kap (Department of Neurosurgery, College of Medicine, Korea University) ;
- Suh, Jung Keun (Department of Neurosurgery, College of Medicine, Korea University)
- 투고 : 2000.12.20
- 심사 : 2001.01.18
- 발행 : 2001.02.28
초록
Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.