A dilemma of most common domain of spontaneous intraparenchymal haemorrhage

Abstract

Background: Spontaneous intraparenchymal haemorrhage (IPH) is the bleeding within brain parenchyma in absence of any kind of trauma or surgery. Spontaneous IPH is serious disabling and deadly one; of all strokes. The most common site of insult is still enigmatic. The reason of our study is to find out the most involved area of brain of spontaneous IPH. Materials & Methods: Our study is prospective type of study. Total 48 numbers of patients were diagnosed as spontaneous intraparenchymal haemorrhage and have first time been reported & admitted in Combined Military Hospital (CMH) Dhaka, between July 2021 and Jan 2022. All of our patients were randomly allocated and sampled as per inclusion and exclusion criteria. Diagnosis was done based upon details history, through clinical examination and releavant investigation. Computed Tomography (CT) scan (non-contrast) of brain was done to authinticate diagnosis and to define site of lesion as well. Data of our study collected by specially designed questionnaire and analyses of statistics was done by Statistical Package for Social Sciences version 26 for Windows (SPSS). Results: In this study 48 cases were finally selected as ‘Spontaneous IPHs’. All of them were diagnosed clinically and confirmed by Computed Tomography scan. In this study, it was revealed that most of the patients were male 37 (77.08%) and female only 11(22.92%) in number. Concerning distribution of age; old age (≥ 60 years) affected 28 (58.33%) than young adult (18-25 years) only 1 (2.08%) in number. It was observed that out of 48 patients; HTN alone 50% (24); next Mixed pathology 16.67% (8) (HTN, Amyloid angiopathy, Coagulopathy, Tumour etc.), then Idiopathic 8.33% (4). In regard to site & side of involvement of IPHs; it was noticed that basal ganglia is more affected 33 in number specially left alone 41.67%, and dominant (left) cerebral hemisphere is more frequent 23( 47.92%) than opposite right (non-dominant) hemisphere 17 (35.42%). Conclusion: Basal ganglia is supplied by a little beat peculier lenticulostriate artey, which is right angle, narrow, end artey and induce atherosclerotic microaneurysm; prone to rupture. Dominant cerebral hemisphere (usually left) is highly metabolically active with having raised blood flow; and highest incidence of IPH is at Basal ganglia of Dominant hemisphere.