高血圧性被殻出血例における予後への規定因子についての検討

Abstract

A total of 32 patients with hypertensive putaminal hemorrhage, who had been admitted within 24 hours of onset, were reviewed. Patients were divided into three groups on the basis of their outcome at hospital discharge, as follows: Group A, 11 patients who were able to walk independently with good or full recovery from hemiparesis; Group B, 9 patients who were able to walk with a cane and 2 patients in wheel chairs; and Group C, 6 patients who required evacuation of hematoma and 4 who had died. We investigated factors affecting outcome by comparing the clinical features during the acute stage and degrees of hypertensive damage to the retina, heart, and kidney of the above three groups. Furthermore, we examined interrelationships among the volume of the hematoma (as calculated from CT scan), systemic blood pressure, and urinary catecholamine excretion in 10 of these patients. The mean age in groups A, B and C was 61.4 +/- 8.1, 58.0 +/- 11.3, and 52.4 +/- 6.8, respectively. The mean volume of hematoma on admission (Day 1) in Group C (50.2 +/- 28.2 ml) was significantly larger than in the other two groups (p less than 0.01, vs Group A: 19.5 +/- 8.8 ml; p less than 0.05, vs Group B: 25.1 +/- 12.6 ml). In Group C, the mean hematoma volume on Day 2 (98.4 +/- 39.5 ml) was significantly larger than the volume on Day 1 (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)