脳幹出血患者の予後予測

Abstract

We evaluated the prognosis of patients 6 months after a brain-stem hemorrhage, based on clinical findings obtained at admission and 1 month after commencement of rehabilitation. Seventeen patients who were admitted to our hospital during the past 2 years with a brain-stem hemorrhage were evaluated at admission and 1 month later, based on the National Institute of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), modified Rankin Scale (mRS), motor paralysis, sensory disturbance, ataxia, blood pressure, and swallowing. To retrospectively examine these evaluation items, the patients were divided into 2 groups: patients who became ambulatory within 6 months (Group A) and patients who did not become ambulatory (Group B). Significant differences were confirmed between groups regarding NIHSS, FIM points, motor paralysis, sensory disturbance, and ataxia at admission and regarding motion capability and mRS at 1 month. At admission, Group A had NIHSS of ≤8.5 (lower limit: 16), FIM of ≥60.7 points (24 points), motor paralysis of Stage IV or higher, and normal to mild sensory disturbance. Moreover, they could retain the sitting position within 1 month, with mRS of Grade 3 or higher (Grade 4 or higher), which indicates their motion capability. Many patients with severe ataxia became ambulatory. Based on these findings, 6-month recovery of patients with brain-stem hemorrhage could be determined based on their achievements at 1 month.