Journal of Korean Neurosurgical Society

  • 제51권5호
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  • Pages.268-271
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  • 2012
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Grading of Intracerebral Hemorrhage in Ruptured Middle Cerebral Artery Aneurysms

  • Shim, Yu-Shik (Department of Neurosurgery, School of Medicine, Konkuk University) ;
  • Moon, Chang-Taek (Department of Neurosurgery, School of Medicine, Konkuk University) ;
  • Chun, Young-Il (Department of Neurosurgery, School of Medicine, Konkuk University) ;
  • Koh, Young-Cho (Department of Neurosurgery, School of Medicine, Konkuk University)
  • 투고 : 2012.01.03
  • 심사 : 2012.05.15
  • 발행 : 2012.05.28
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초록

Objective : To propose grading of intracerebral hemorrhage (ICH) in ruptured middle cerebral artery (MCA) aneurysms, which helps to predict the prognosis more accurately. Methods : From August 2005 to December 2010, 27 cases of emergent hematoma evacuation and aneurysm clipping for MCA aneurysms were done in the author's clinic. Three variables were considered in grading the ICH, which were 1) hematoma volume, 2) diffuse subarachnoid hemorrhage (SAH) that extends to the contralateral sylvian cistern, and 3) the presence of midline shifting from computed tomography findings. For hematoma volume of greater than 25 mL, we assigned 2 points whereas 1 point for less than 25 cc. We also assigned 1 point for the presence of diffuse SAH whereas 0 point for the absence of it. Then, 1 point was assigned for midline shifting of greater than 5 mm whereas 0 point for less than 5 mm. Results : According to the grading system, the numbers of patients from grade 1 to 4 were 4, 6, 8 and 9 respectively and 5, 7, 8, 4 and 3 patients belonged to Glasgow Outcome Scale (GOS) 5 to 1 respectively. It was found that the patients with higher GOS had lower ICH grade which were confirmed to be statistically significant (p<0.01). Preoperative Hunt and Hess grade and absence of midline shifting were the factors to predict favorable outcome. Conclusion : The ICH grading system composed of above three variables was helpful in predicting the patient's outcome more accurately.

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참고문헌

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피인용 문헌

  1. Comparative Results of the Patients with Intracerebral and Intra-sylvian Hematoma in Ruptured Middle Cerebral Artery Aneurysms vol.15, pp.3, 2012, https://doi.org/10.7461/jcen.2013.15.3.200
  2. Pure subdural haematoma caused by rupture of middle cerebral artery aneurysm: Case report and literature review vol.42, pp.3, 2014, https://doi.org/10.1177/0300060514524929
  3. Subarachnoid hemorrhage and intracerebral hematoma caused by aneurysms of the anterior circulation: influence of hematoma localization on outcome vol.37, pp.4, 2012, https://doi.org/10.1007/s10143-014-0560-8
  4. Importance of Hematoma Removal Ratio in Ruptured Middle Cerebral Artery Aneurysm Surgery with Intrasylvian Hematoma vol.19, pp.1, 2012, https://doi.org/10.7461/jcen.2017.19.1.5
  5. Ruptured giant aneurysm of a cortical middle cerebral artery: A case report vol.12, pp.None, 2021, https://doi.org/10.25259/sni_952_2020