Analysis of the Results of the Treatment According to the Change of Neurological Status in Hypertensive Putaminal Hemorrhage

Huh, Pil Woo; Park, Young Sup; Chung, Dong Sup; Lee, Gil Song; Choi, Seong Jin; Park, Chun Keun; Lee, Sang Won; Choi, Chang Rack

Abstract

One hundred and twenty four patients with hypertensive putaminal hemorrhage were analyzed by time course. All patients were brought to the emergency room within 3 hours after the ictus. Seventy three patients were conservatively treated and 51 patients operatively. The neurologic condition of each patient was evaluated by means of the Glasgow coma scale(GCS) score every 1 hour. CT scan of the brain of these patients were taken within 6 hours after the ictus. Clinical severity of the putaminal hemorrhage was graded as rapid deterioration, slow deterioration, and non deterioration by the CT and neurological status. A precise time course analysis of putaminal hemorrhage were compared with the conservative group and surgical group in a 7 hospital day period. Outcome was assessed 6 months later based on the degree of functional recovery(DOFR). The overall mortality was 16.1% and surgical mortality was 13.7%. Surgical treatment for the rapidly deteriorating patients appears to be beneficial when compared with the slowly deteriorating patients. Outcome of the non deteriorating patients didn't show any differences in the quality of life regardless of treatment modality.