A clinical analysis of 32 brainstem haemorrhages; With special reference to surviving but severely disabled cases
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Thirty-two patients with CT-documented primary brainstem haemorrhage were reviewed retrospectively to obtain a clearer overall clinical picture, especially of the severely disabled survivors. They were divided into 3 groups according to outcome: eleven cases (Group 1) died within 1 month following haemorrhage, 11 cases (Group 2) survived but became bedridden, necessitating full living support, and 10 cases (Group 3) showed minimal neurological deficits and resumed normal activities. Owing to CT and improved critical care, the survival rate was 66% for the whole series. Group 2 comprised 34% of all cases. These patients were mostly alert, quadruplegic, and communicated only with great difficulty.
The most common initial symptoms and CT finding in each group were as follows;Group 1: unconsciousness, respiratory disturbance, negative light reflex, tachycardia, and haematoma >3.0 cm;Group 2: disturbance of consciousness, respiratory disturbance, positive light reflex, normal heart rate, and 2.0> haematoma <3.5 cm; andGroup 3: alertness or only slight disturbance of consciousness, normal respiration, positive light reflex, normal heart rate, haematoma <2.5 cm. Although there is an overlap among them, these findings will be useful to distinguish the three groups from each other. Patients with disturbance of consciousness, respiratory disturbance, positive light reflex, normal heart rate, and 2.0> haematoma <3.5 cm, have a chance to survive, but in severely disabled condition, if they were treated with vigorous intensive care in the acute stage.
KeywordsBrainstem haemorrhage CT scan outcome
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- 4.Koga N, Hosaka Y, Sugimura J, Sakakibara T, Takagi S (1985) Clinical analysis of pontine hemorrhage—Correlations between clinical sign, computed tomographic findings and prognosis. Jpn J Stroke (in Japanese) 7: 50–55Google Scholar
- 7.Kushner MJ, Bressman SB (1985) The clinical manifestations of pontine hemorrhage. Neurology (Cleveland) 35: 637–643Google Scholar
- 8.Kuwabara S, Ohta K, Ueda T, Yamane K, Uemura Y, Takahashi M (1982) Clinical study of 20 cases of primary pontine hemorrhage. With special reference to correlations between clinical, computed tomographic, and electroencephalographic findings and outcome. Neurol Med Chir (in Japanese) 22: 933–942Google Scholar
- 12.Ochiai C, Sano K, Kobayashi S, Sasaki T, Mayanagi Y (1979) Clinical study of pontine hemorrhage with special reference to CT. Classification and surgical indication. Brain Nerve (in Japanese) 31: 803–811Google Scholar
- 15.Tanaka Y, Nishiya M, Ogasawara S, Nakamura J, Suematsu K (1982) Clinical study of hypertensive pontine hemorrhage. Brain Nerve (in Japanese) 34: 601–607Google Scholar
- 17.Yamanaka R, Sato S, Kawasaki S, Sekiguchi K, Sato I, Mori S, Watanabe M, Nishizawa E, Morii K, Takahama H, Kuroki A, Hirabayashi K, Mori M, Yokoyama J, Suzuki H (1988) Clinical study of primary pontine hemorrhage. Neurol Surg (in Japanese) 16: 57–64Google Scholar