• Journal of Computing Science and Engineering
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• v.11 no.4
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• pp.142-151
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• 2017

Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that sICH occurrence is related to weather conditions; therefore, this study used the decision tree method to explore the impact of climatic risk factors on sICH at different ages. The Taiwan National Health Insurance Research Database (NHIRD) and other open-access data were used in this study. The inclusion criterion was a first-attack sICH. The decision tree algorithm and random forest were implemented in R programming language. We defined a high risk of sICH as more than the average number of cases daily, and the younger, middle-aged and older groups were calculated as having 0.77, 2.26 and 2.60 cases per day, respectively. In total, 22,684 sICH cases were included in this study; 3,102 patients were younger (<44 years, younger group), 9,089 were middle-aged (45-64 years, middle group), and 10,457 were older (>65 years, older group). The risk of sICH in the younger group was not correlated with temperature, wind speed or humidity. The middle group had two decision nodes: a higher risk if the maximum temperature was >$19^{\circ}C$ (probability = 63.7%), and if the maximum temperature was <$19^{\circ}C$ in addition to a wind speed <2.788 (m/s) (probability = 60.9%). The older group had a higher risk if the average temperature was >$23.933^{\circ}C$ (probability = 60.7%). This study demonstrated that the sICH incidence in the younger patients was not significantly correlated with weather factors; that in the middle-aged sICH patients was highly-correlated with the apparent temperature; and that in the older sICH patients was highly-correlated with the mean ambient temperature. "Warm" cold ambient temperatures resulted in a higher risk of sICH, especially in the older patients.

• Korean Journal of Adult Nursing
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• v.17 no.3
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• pp.464-473
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• 2005

Purpose: The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. Methods: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. Results: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H=15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. Conclusion: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.213-216
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• 2010

Spontaneous intracerebral hemorrhage (ICH) is a common condition that often leads to death or disability. Accurate prediction of the outcome and decisions regarding the treatment of ICH patients are important issues. We report a case of thalamic hemorrhage with an intraventricular hemorrhage that was suddenly migrated into the third and fourth ventricles in its entirety 8 hours after symptom onset. To our knowledge, this case is the first report of spontaneous migration of thalamic ICH into ventricles, and we suggest a possible mechanism for this case with a brief review of the literature.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.303-309
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• 2014

Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.35-44
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• 1991

Recently many authors have reported about the relationship of the volumes of hemorrhage in the brain parenchyme, hemorrhagic sites, optimal operation time, and the effects of mannitol and steroid on control of ICP to clinical manifestations. Many attempts to measue ICP in hydrocephalus, brain tumor, and head injury have been reported. But the measurements of intracranial pressure in spontaneous intracerebral hemorrhage are rare. Intracranial pressure was monitored prospectively in 30 patients who had stereotaxic surgery for spontaneous intracerebral hemorrhage. The results are as follows. 1. Intracranial pressure was increased in high $PaCO_2$. 2. There were no correlation in ICP, rebleeding and ADL at discharge(P > 0.05). 3. ICP was the most high level in 72 hours after operation. 4. There was 63.2% decrease in ICP after litigation with 6000 IU urokinase in the site of hemorrhage. 5. There was no correlation between the numbers of natural drainage and ADL at discharge(P > 0.05). 6. The higher the initial GCS, the higher the Postoperative GCS.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.61-64
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• 2005

We report a 18-year-old man, who has been taking antihypertensive medication for 1month in a local clinic, presented with a sudden onset headache followed by left blindness. He experienced palpitation and chest discomfort during physical exertion since 2years before admission, but unfortunately has been ignored. Brain CT showed intracerebral hemorrhage in the left temporoparietal area, but cerebral angiogram and magnetic resonance image revealed no vascular anomaly. He was managed conservatively, and headache and visual loss were improved over time. Subsequently, on the evaluation of hypertension, he was diagnosed as having extra-adrenal pheochromocytoma on left paraaortic area from the results of endocrinological evaluations, abdominal CT scan, and $^{131}I$-MIBG scintigraphy.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.259-265
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• 2001

Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.197-200
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• 2005

Objective: Ultrasound can be used in the treatment of large intracerebral hematoma. The authors present our experiences with Ultrasound-guided catheter placement for lysis and drainage of ganglionic hematoma, with emphasis on technical aspects. Methods: The authors applied real-time ultrasonography for the aspiration of intracerebral hematoma in 6cases. Ultrasound-guided aspiration via a burrhole was performed under local anesthesia. We selected a temporal entry point instead of the frequently used precoronal approach in ganglionic hematoma. A burrhole was made 4 to 6cm posterior from posterior border of frontal process of the zygomatic bone at the level of 4 to 5cm above the external auditory meatus. Results: In all patients, the catheter was placed accurately into the hematoma target. All patients were irrigated with urokinase once to three times a day. The catheter could be removed within two or three days. The mean hematoma volume was reduced from initially 32mL to 5mL in an average of two days. There were no intraoperative complications related to the use of real-time ultrasonography and no postoperative infections were noted. Conclusion: Ultrasound allows an easy and precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.373-378
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• 2015

Objective : To determine the advantages of parietal approach compared to Kocher's point approach for spontaneous, oval-shaped intracerebral hemorrhage (ICH) with expansion to the parietal region. Methods : We divided patients into two groups : group A had burr holes in the parietal bone and group B had burr holes at Kocher's point. The hematoma volume, Glasgow coma scale (GCS) score, and modified Barthel Index (mBI) score were calculated. At discharge, we evaluated the patients' Glasgow outcome scale (GOS) score, modified Rankin Scale (mRS) score, motor grade, and hospitalization duration. We evaluated the patients' mBI scores and motor grades at 6 months after surgery. Results : The hematoma volume in group A was significantly less than that in group B on postoperative days 1, 3, 5, 7, 14, and 21. Group A had significantly higher GCS scores than did group B on postoperative days 1 and 3. Group A had higher mBI scores postoperatively than did group B, but the scores were not significantly different. No differences were observed for the GOS score, mRS score, motor grade at discharge, or duration of hospitalization. The mBI score of group A at 6 months after surgery was significantly higher, and more patients in group A showed muscle strength improvement. Conclusion : In oval-shaped ICH with expansion to the parietal region, the parietal approach is considered to improve the clinical symptoms at the acute phase by removing the hematoma more effectively in the early stages. The parietal approach might help promote the long-term recovery of motor power.

• Journal of Sasang Constitutional Medicine
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• v.14 no.2
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• pp.106-114
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• 2002

The etiology of spontaneous intracerebral hematoma is aneurysmal rupture, arteriovenous malfomation, brain rumor, blood dyscrasia, cerebral infaction, cerebra inflammatory vascular disease, hypertension, and unknown causes. And the primary intracerebral hematoma is caused by unknown causes including hypertension. The clinical diagnosis of intracerebral hematoma, size, location, ventricular penetration, and evolution of brain parenchyme by hemorrhage are confirmed by CT scan. The authors have experienced 1 case of spontaneous intracerebral hematoma confirmed by CT scan. We have diagnosed the patient as Soyangin and treated by east integrated therapy. We classified this case as Soyangin-liyoiljung(少陽人裏熱證) and prescribed Yangkyuksanhwatang' Jihwangbaekhotang Hyungbangsabaeksan to the principle of Cheongyangsangsung(淸陽上升). In the result, we had the improvement of the symptoms. This report discribed the process and contents about the way the patient was cured.