Risk Factors in Patients with Rebleeding after CT-Guided Stereotactic Burr Hole Aspiration for Hypertensive Intracerebral Hematoma

Jung, Hyun Sik; Hamm, In Suk; Kim, Dae Hyun; Sung, Joo Kyung; Kim, Seung Lae

Abstract

This retrospective comparative study involved 282 hypertensive intracerebral hemorrhage patients admitted to Kyungpook University Hospital between January 1991 and January 1993 for the evaluation of clinical risk factors of rebleeding. For all patients, surgery involved CT-guided stereotactic burr-hole aspiration. In 39(13.8%), postoperative rebleeding occurred at the site of the hematoma. The mean age of both the rebleeding and non-rebleeding group was 58. In the rebleeding group, the male to female ratio was 19:20(1:1.1), and in the non-rebleeding group, the corresponding figure was 113:130(1:1.5). The amount of intracerebral hematoma appearing on brain CT during the 24 hours following surgery was measured and defined as rebleeding in cases where the amount was the same as or more than before surgery. In comparative analysis, the authors defined the following hypothetical clinical risk factors: age, location of hematoma, pre-op systolic blood pressure, volume of hematoma, pre-op consciousness, time interval from hemorrhage ictus to operation, past history and systemic disease. Through analysis of rebleeding cases, these risk factors were then compared: p-value was estimated by use of the chi-square test. In conclusion, clinical risk factors in rebleeding were found to be high systolic blood pressure prior to surgery, poor pre-op clinical grade, small amount of hematoma, short time interval from hemorrhage ictus to operation(6-24 hours), and a past history of cerebrovascular disease.