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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Čes. a Slov. Neurol. Neurochir., 61/94, 1998, No. 6, p. 312–320. |
Relationship between Mortality from Spontaneous Intracranial Haemorrhages and the Size, Site, Behaviour of the Haemorrhage and the Patients’ Age Herzig R., Buřval S., Vlachová I., Urbánek K., Křupka B. Neurologická klinika LF a FN, Olomouc 1 Radiologická klinika LF a FN, Olomouc |
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Summary: Objective: The objective of this retrospective study was to evaluate the relationship
between the mortality from spontaneous intracranial haemorrhages and the size, site,
behaviour of the haemorrha- ge and the patients’ age. Clinical group and methods: The
authors evaluated a group of 202 patients with spontaneous intracranial haemorrhages. Of
137 intracerebral haemorrhages 46% were in the basal ganglia, 31% were lobar, 11% in the
thalamus, 7% in the cerebellum and 5% in the brain stem. In all patients the site of the
haemorrhage was evaluated by CT as well as its size (according to the longest axis) and
the midline-shift. The authors investigated the relationship between 30-day mortality, the
above mentioned factors and the patients’ age. The statistical significance was
evaluated by means of the c 2 test. Results: The mortality from
intracerebral haemorrhages increased significantly with the patients’ age: 10–49
years: 0%, 50–59 years: 10 %, 60–69 years: 29%, 70–79 years: 43%, 80–99 years: 54%
(p = 0.00002). There was also a significant age-conditioned increase of mortality from
subarachnoidal and intraventricular haemorrhages – 10–59 years: 0%, 60–79 years:
31%, 80–99 years: 50% (p = 0.0009). The mortality of supratentorial intracerebral
haemorrhages without the intraventricular component (and with the intraventricular
component resp.) increased significantly in relation to the size of the haemorrhage – 1–19
mm: 0% (17%), 30–39 mm: 19% (40%), 40–49 mm: 15% (40%), 50–69 mm: 36% (36%), 70–99
mm: 44% (89%) (p = 0.04 and p = 0.05 resp.). The authors also provided evidence of a close
correlation between the increase in mortality from spontaneous intracranial haemorrhages
and the midlineshift – 0 mm: 12%, 1 mm: 30%, 2 mm: 31%, 3 mm: 46%, 4 – 7 mm: 50%, 8
– 11 mm: 56%, 12 – 30 mm: 67% (p = 0.00002). Conclusion: The mortality from
spontaneous intracranial haemorrhages increases signi- ficantly in relation to the
patients’ age and the midline-shift associated with the haemorrhage. The mortality from
spontaneous supratentorial intracerebral haemorrhages increases significantly in relation
to the size of the haemorrhage and intraventricular penetration of blood. The evaluation
of the above factors can be used for prediction of the condition development of patients
with those haemorrhages. Key words: spontaneous cerebral haemorrhage, prognosis, mortality
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