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Lobar vs thalamic and basal ganglion hemorrhage: clinical and radiographic features

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Summary

One hundred and twelve patients with spontaneous supratentorial intracerebral hemorrhages were reviewed to identify features which distinguish lobar intracerebral hemorrhage (LH; n=42) from thalamic or basal ganglionic hemorrhage (TGH; n=70). Chronic hypertension occurred more commonly in TGH (TGH 67%; LH 48%) while bleeding diathesis was more common in LH (LH 19%; TGH 6%). Clinical presentations were extremely variable and not associated with the type of hemorrhage. Bleeding into the ventricles and hydrocephalus occurred more often with TGH. At last follow-up, there were minimal differences between LH and TGH in overall mortality and functional outcome of the survivors. Alertness on admission was associated with a good outcome regardless of the type of hemorrhage, while a low Glasgow Coma Scale score, coma, ataxic respiration, abnormal pupil reactions, acute hypertension, large hemorrhage size and intraventricular blood were associated with a poor outcome. These data confirm etiological distinctions between LH and TGH, but fail to confirm previously reported differences in clinical presentation and outcome.

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References

  1. Barraquer-Bordas L, Illa I, Escartin A, Ruscalleda J, Marti-Vilalta JL (1984) Thalamic hemorrhage: a study of 23 patients with diagnosis by computed tomography. Stroke 12:524–7

    Google Scholar 

  2. Bolander HG, Kourtopoulos H, Liliequist B, Wittboldt S (1983) Treatment of spontaneous intracerebral hemorrhage: a retrospective analysis of 74 consecutive cases with special reference to computer tomographic data. Acta Neurochir 67:19–28

    Google Scholar 

  3. Delaney P, Estes Mer AH (1980) Intracranial hemorrhage with amphetamine abuse. Neurology 30:1125–8

    Google Scholar 

  4. Douglas MA, Haerer AF (1982) Long-term prognosis of hypertensive intracerebral hemorrhage. Stroke 13:488–91

    Google Scholar 

  5. Freytag E (1968) Fatal hypertensive intracerebral hematomas: a survey of the pathological anatomy of 393 cases. J Neurol Neurosurg Psychiatry 31:616–20

    Google Scholar 

  6. Garde A, Bohmer G, Selden B, Neiman J (1983) 100 cases of spontaneous intracerebral hematoma. Eur Neurol 22:161–72

    Google Scholar 

  7. Helweg-Larsen S, Sommer W, Strange P, Lester J, Boysen G (1984) Prognosis for patients treated conversatively for spontaneous intracerebral hematomas. Stroke 15:1045–8

    Google Scholar 

  8. Hinton DR, Dolan E, Sima AA (1984) The value of histopathological examination of surgically removed blood clot in determining the etiology of spontaneous intracerebral hemorrhage. Stroke 15:517–20

    Google Scholar 

  9. Jennett B, Teasdale LG (1984) Management of head injuries. Davis, Philadelphia, pp 77–84

    Google Scholar 

  10. Kalyan-Raman UP, Kalyan-Raman K (1984) Cerebral amyloid angiopathy causing intracranial hemorrhage. Ann Neurol 16:321–9

    Google Scholar 

  11. Kase CS, Williams JP, Wyatt DA, Mohr JP (1982) Lobar intracerebral hematomas: clinical and CT analysis of 22 cases. Neurology 32:1146–50

    Google Scholar 

  12. Kaufman D, Portenoy RK, Lesser ML, Tabaddor K (1984) Changes in a follow-up study and the influence of race and other factors on outcome in intracranial surgery for cerebral artery aneurysms. NY State J Med 84:549–53

    Google Scholar 

  13. Kwak R, Kadoya S, Suzuki T (1983) Factors affecting the prognosis in thalamic hemorrhage. Stroke 14:493–500

    Google Scholar 

  14. McCormick WF, Rosenfield DB (1973) Massive brain hemorrhage: a review of 144 cases and an examination of their causes. Stroke 4:946–54

    Google Scholar 

  15. Mohr JP, Caplan LR, Melski JW, Goldstein RJ, Duncan GW, Kistler JP, Pessin MS, Bleich HL (1978) Clinical findings in intracerebral hemorrhage from the Harvard Stroke Registry. Neurology 28:754–762

    Google Scholar 

  16. Paillas JE, Alliez B (1973) Surgical treatment of spontaneous intracerebral hemorrhage. Neurosurgery 39:145–51

    Google Scholar 

  17. Portenoy RK, Lipton RB, Berger AR, Lesser ML, Lantos G (1986) Intracerebral hemorrhage: a model for the prediction of outcome. J Neurol Neurosurg Psychiatry (in press)

  18. Ropper AH, Davis KR (1980) Lobar cerebral hemorrhages: acute clinical syndrome in 26 cases. Ann Neurol 8:141–7

    Google Scholar 

  19. Stein RW, Caplan LR, Hier DB (1983) Outcome of intracranial hemorrhage: role of blood pressure and location and size of lesions. Ann Neurol 14:132

    Google Scholar 

  20. Steiner I, Gomori JM, Melamed E (1984) The prognostic value of the CT scan in conservatively treated patients with intracerebral hematoma. Stroke 15:279–82

    Google Scholar 

  21. Volpin L, Cervellini P, Colombo F, Zanusso M, Benedetti LA (1984) Spontaneous intracerebral hematomas: a new proposal about the usefulness and limited of surgical treatment. Neurosurgery 15:663–6

    Google Scholar 

  22. Waga S, Yamamoto Y (1983) Hypertensive putaminal hemorrhage: treatment and results. Stroke 14:480–4

    Google Scholar 

  23. Walshe TM, Davis KR, Fisher CM (1977) Thalamic hemorrhage: a computerized tomographic-clinical correlation. Neurology 27:217–22

    Google Scholar 

  24. Weisberg LA (1979) Computerized tomography in intracranial hemorrhage. Arch Neurol 36:422–6

    Google Scholar 

  25. Wigins WS, Moody JF, Toole JF, Laster DW, Ball MR (1978) Clinical and computerized tomographic study of hypertensive intracerebral hemorrhage. Arch Neurol 35:832–833

    Google Scholar 

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Lipton, R.B., Berger, A.R., Lesser, M.L. et al. Lobar vs thalamic and basal ganglion hemorrhage: clinical and radiographic features. J Neurol 234, 86–90 (1987). https://doi.org/10.1007/BF00314107

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  • DOI: https://doi.org/10.1007/BF00314107

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