Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38
Filtrar
2.
J Assoc Physicians India ; 66(9): 93-94, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31321941

RESUMO

Toluene is an aromatic hydrocarbon that is often used as a solvent in paints, paint thinners, glues, disinfectants and as an industrial solvent for the manufacturing of pharmaceuticals, paints and chemicals. Metabolic acidosis is a recognized complication of toluene poisoning. However, we here report an unusual case of toluene poisoning presenting with bilateral intracerebral haemorrhage.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Tolueno/envenenamento , Hemorragia dos Gânglios da Base/etiologia , Humanos , Pintura , Solventes
4.
Medicine (Baltimore) ; 95(23): e3838, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27281090

RESUMO

It is important to estimate motor recovery in the early phase after stroke. Many studies have demonstrated that both diffusion tensor tractography (DTT) and motor-evoked potentials (MEP) are valuable predictors of motor recovery, but these modalities do not directly reflect the status of the injured gray matter. We report on 2 subjects with basal ganglia hemorrhage who showed similar DTT and MEP findings, but had markedly different clinical outcomes. Specifically, Subject 1 showed no improvement in motor function, whereas Subject 2 exhibited substantial improvement 7 weeks after onset. To determine if differences in gray matter might lend insight into these different outcomes, we analyzed gray matter lesions of the 2 subjects using a novel voxel-based lesion mapping method. The lesion of Subject 1 mainly included the putamen, thalamus, and Heschl's gyri, indicating extension of the hemorrhage in the posterior direction. In contrast, the lesion of Subject 2 mainly included the putamen, insula, and pallidum, indicating that the hemorrhage extended anterior laterally. These differential findings suggest that voxel-based gray matter lesion mapping may help to predict differential motor recovery in subjects with basal ganglia hemorrhage with similar DTT and MEP findings.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Mapeamento Encefálico/métodos , Imagem de Tensor de Difusão/métodos , Atividade Motora/fisiologia , Tratos Piramidais/diagnóstico por imagem , Recuperação de Função Fisiológica/fisiologia , Adulto , Hemorragia dos Gânglios da Base/fisiopatologia , Potencial Evocado Motor/fisiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tratos Piramidais/fisiopatologia
5.
Eur Rev Med Pharmacol Sci ; 19(14): 2614-20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26221891

RESUMO

OBJECTIVE: To explore the therapeutic effect of neuronavigation-assisted minimally invasive operation on hypertensive basal ganglia hemorrhage patients with hematoma volume less than 30 mL. PATIENTS AND METHODS: 25 hypertensive basal ganglia hemorrhage patients with hematoma volume varied from 15 to 30 mL were enrolled. 13 patients were recuited to undertook puncture aspiration and catheter drainage under real-time neuronavigation. The operations were carried out under CT imaging guidance. Twelve patients with conservative treatment were recruited as control. RESULTS: Neuronavigation operation group was superior to the conservative treatment group in terms of hematoma clearance time, duration of hospitalization, 6-month Glasgow coma score (GCS) scores and neurological deficiency scores. CONCLUSIONS: Neuronavigation-assisted minimally invasive operation is suitable for low volume hypertensive basal ganglia hemorrhage and improves the prognosis of these patients significantly.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/cirurgia , Hipertensão/diagnóstico , Hipertensão/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neuronavegação/métodos , Adulto , Feminino , Hematoma/diagnóstico , Hematoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
6.
Clin Chim Acta ; 425: 85-9, 2013 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-23916712

RESUMO

BACKGROUND: Visfatin, a proinflammatory mediator, has been associated with poor clinical outcomes after acute brain injury. The present study is designed to investigate the potential association between plasma visfatin levels and the risk of hematoma growth (HG) and early neurologic deterioration (END) after intracerebral hemorrhage. METHODS: There were 85 patients as cases who presented with first-time hemorrhagic stroke that were assessed within 6h after the incident. The control group consisted of 85 healthy volunteers. HG was defined as hematoma enlargement >33% at 24h. END was defined as an increase of ≥ 4 points in National Institute of Health Stroke Scale score at 24h from symptoms onset. Plasma visfatin levels were determined using enzyme immunoassay. RESULTS: Plasma visfatin levels were significantly higher in patients compared to controls. Plasma visfatin level emerged as an independent predictor of HG [odds ratio (OR), 1.154; 95% confidence interval (CI), 1.046-3.108; P=0.009] and END (OR, 1.195; 95% CI, 1.073-3.516; P=0.005). For predicting HG, area under curve (AUC) of plasma visfatin level (0.814; 95% CI: 0.715-0.890) was similar to that of hematoma volume (0.839; 95% CI, 0.743-0.909) (P=0.703). For predicting END, AUC of plasma visfatin level (0.828; 95% CI: 0.730-0.901) was similar to that of hematoma volume (0.863; 95% CI, 0.771-0.928) (P=0.605). Visfatin did not improve AUC of hematoma volume for predicting HG and END (both P>0.05). CONCLUSION: Plasma visfatin level represents a novel biomarker for predicting HG and END.


Assuntos
Hemorragia dos Gânglios da Base/sangue , Biomarcadores/sangue , Disfunção Cognitiva/sangue , Citocinas/sangue , Hematoma/sangue , Nicotinamida Fosforribosiltransferase/sangue , Idoso , Área Sob a Curva , Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/fisiopatologia , Estudos de Casos e Controles , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/fisiopatologia , Citocinas/genética , Feminino , Expressão Gênica , Hematoma/diagnóstico , Hematoma/fisiopatologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Nicotinamida Fosforribosiltransferase/genética , Prognóstico , Curva ROC , Fatores de Tempo
7.
Peptides ; 45: 35-9, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23659863

RESUMO

Higher plasma leptin levels have been associated with poor clinical outcomes after intracerebral hemorrhage. Nevertheless, their links with hematoma growth and early neurological deterioration are unknown. Therefore, we aimed to investigate the relationship between plasma leptin levels, hematoma growth, and early neurological deterioration in patients with acute intracerebral hemorrhage. We prospectively studied 102 consecutive patients with acute spontaneous basal ganglia hemorrhage presenting within 6h from symptoms onset. Significant hematoma growth was defined as hematoma enlargement >33% at 24h. Early neurological deterioration was defined as an increase of ≥4 points in National Institute of Health Stroke Scale score at 24h from symptoms onset. We measured plasma leptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma leptin level emerged as the independent predictor of hematoma growth (odds ratio, 1.182; 95% confidence interval, 1.061-2.598; P=0.008) and early neurological deterioration (odds ratio, 1.193; 95% confidence interval, 1.075-2.873; P=0.004). Using receiver operating characteristic curves, we calculated areas under the curve for hematoma growth (area under curve, 0.844; 95% confidence interval, 0.759-0.908) and early neurological deterioration (area under curve, 0.857; 95% confidence interval, 0.774-0.918). The predictive performance of leptin was similar to, but did not obviously improve that of hematoma volume. Thus, leptin may help in the prediction of hematoma growth and early neurological deterioration after intracerebral hemorrhage.


Assuntos
Hemorragia dos Gânglios da Base/sangue , Hemorragia dos Gânglios da Base/fisiopatologia , Hematoma/sangue , Leptina/sangue , Idoso , Área Sob a Curva , Hemorragia dos Gânglios da Base/diagnóstico , Biomarcadores/sangue , Estudos de Casos e Controles , Progressão da Doença , Feminino , Hematoma/diagnóstico , Hematoma/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC
8.
Acta Neurochir Suppl ; 118: 139-42, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23564120

RESUMO

Twenty patients with traumatic basal ganglia hematoma (TBGH) were studied. Of the 20 patients, 16 were male and 4 were female, with an age range of 4-89 years (mean, 54.4 years). The causes of injury were traffic accidents in 12 patients and falls in 8. The mean admission GCS score was 7.5. Skull fractures were revealed in five patients (25 %). The hematoma was found in the putamen in 15 patients (80 %), the thalamus in 4, and the caudate in 1. The mean hematoma volume was 10.7 mL. The CT findings indicated focal contusions in 9 patients, subdural hematoma in 5, intraventricular hemorrhage in 4, subarachnoid hemorrhage in 10, and diffuse axonal injury in 5. Six patients (30 %) underwent surgery. The final outcomes were poor: 7 patients (35 %) died, 1 was in a vegetative state, 4 experienced severe disabilities, and 8 patients (40 %) made a favorable recovery. The statistical analysis identified the GCS score and midline shift as prognostic factors.Our study revealed interesting characteristics of TBGH, including a high frequency of putaminal involvement, a low frequency of skull fractures, a high frequency of associated intracranial lesions, and a high poor outcome and mortality rate.


Assuntos
Hemorragia dos Gânglios da Base , Gânglios da Base/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Gânglios da Base/diagnóstico por imagem , Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/fisiopatologia , Hemorragia dos Gânglios da Base/terapia , Criança , Pré-Escolar , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Brain Inj ; 27(4): 500-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23472761

RESUMO

BACKGROUND: Bilateral traumatic basal ganglia haematoma is an extremely rare event in traumatic brain injuries, with only five reported cases. The presumed mechanism is due to shearing forces leading to haemorrhage from the lenticulostriate or anterior choroidal artery. The prognosis appears to be dependent on the extent and severity of underlying brain injury. CASE STUDY: A case of a 38 year old fully conscious male, who presented with bilateral basal ganglia haematoma and extradural haematoma, is presented and the relevant literature is briefly reviewed.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/etiologia , Lesões Encefálicas/complicações , Lesões Encefálicas/diagnóstico , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/etiologia , Acidentes por Quedas , Adulto , Hemorragia dos Gânglios da Base/reabilitação , Lesões Encefálicas/reabilitação , Estado de Consciência , Hematoma Epidural Craniano/reabilitação , Humanos , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento
10.
J Neuroimaging ; 23(1): 122-5, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21899647

RESUMO

Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized acute cerebrovascular condition that may produce myriad transient and sustained neurologic deficits as well as a host of radiologic features. We report the case of a woman with RCVS and a severe clinical syndrome with bilateral basal ganglia hemorrhages, cerebral infarctions, and marked vascular abnormalities. The patient made a near complete clinical recovery, representing an extreme and illustrative form of RCVS.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Angiografia Cerebral/métodos , Transtornos Cerebrovasculares/diagnóstico , Doença Aguda , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome
11.
BMJ Case Rep ; 20122012 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-23188852

RESUMO

A 57-year-old man was admitted with right arm weakness and numbness on the background of intermittent headaches. On examination he was found to have mildly decreased sensation, power was 4/5 on the right side. He had dyspraxia in the right hand and was unable to spell his name. His speech was hesitant and he had left-sided visual field impairment as well as some photophobia. MRI and CT revealed multiple areas of haemorrhage and infarctions raising the possibility of primary angitis of brain. The biopsy confirmed the diagnosis. The patient responded to steroids and immunosuppressants partially.


Assuntos
Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia , Vasculite do Sistema Nervoso Central/complicações , Vasculite do Sistema Nervoso Central/diagnóstico , Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/etiologia , Hemorragia dos Gânglios da Base/patologia , Biópsia , Encéfalo/patologia , Angiografia Cerebral , Artérias Cerebrais/patologia , Infarto Cerebral/diagnóstico , Infarto Cerebral/etiologia , Infarto Cerebral/patologia , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Acidente Vascular Cerebral/patologia , Tomografia Computadorizada por Raios X , Vasculite do Sistema Nervoso Central/patologia
12.
BMC Neurol ; 12: 34, 2012 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-22676908

RESUMO

BACKGROUND: Spontaneous intracerebral hemorrhage is a disease with high morbidity, high disability rate, high mortality, and high economic burden. Whether patients can benefit from surgical evacuation of hematomas is still controversial, especially for those with moderate-volume hematomas in the basal ganglia. This study is designed to compare the efficacy of endoscopic surgery and conservative treatment for the moderate-volume hematoma in spontaneous basal ganglia hemorrhage. METHODS: Patients meet the criteria will be randomized into the endoscopic surgery group (endoscopic surgery for hematoma evacuation and the best medical treatment) or the conservative treatment group (the best medical treatment). Patients will be followed up at 1, 3, and 6 months after initial treatment. The primary outcomes include the Extended Glasgow Outcome Scale and the Modified Rankin Scale. The secondary outcomes consist of the National Institutes of Health Stroke Scale and the mortality. The Barthel Index(BI) will also be evaluated. The sample size is 100 patients. DISCUSSION: The ECMOH trial is a randomized controlled trial designed to evaluate if endoscopic surgery is better than conservative treatment for patients with moderate-volume hematomas in the basal ganglia. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-TRC-11001614(http://www.chictr.org/en/proj/show.aspx?proj=1618).


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/terapia , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/terapia , Adolescente , Adulto , Idoso , Hemorragia dos Gânglios da Base/complicações , Endoscopia , Feminino , Hematoma Epidural Craniano/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
13.
J Clin Neurosci ; 19(2): 277-80, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22118795

RESUMO

The risk of basal ganglia hemorrhage (BGH) increases in patients of older age and with hypertension. Current guidelines do not recommend routine vascular imaging. However, a proportion of patients with BGH have underlying vascular abnormalities, and these patients may require a different treatment approach. We aimed to assess the proportion of underlying vascular abnormalities in patients with BGH. In this retrospective study, we included all patients who presented with BGH between January 2007 and December 2009 at a single institution. The following data were collected: patient demographics, vascular risk factors, medications, volume of hematoma, CT scans, CT angiogram, magnetic resonance angiography and digital subtraction angiography. We determined the proportion of underlying vascular abnormalities and correlated these findings with risk factors for BGH. A total of 113 consecutive patients with BGH were identified, and vascular imaging was performed in 61. The median age was 62 years and 48 (78.7%) of these patients were male. Forty-two (68.9%) of 61 patients had hypertension. Positive vascular imaging findings were identified in eight of 61 patients (13.1%): three intracranial aneurysms, three cavernous malformations, one Moyamoya disease and one arteriovenous malformation. There were no significant associations between demographic features, vascular risk factors and the hematoma volume between patients with positive and negative vascular imaging. Specifically, an underlying vascular abnormality was not associated with age (≥ 60 years, 6/36 patients had an underlying vascular abnormality, compared with 2/25 patients< 60 years; p=not significant [n.s.]). There was no relationship with hypertension (5/42 hypertensive patients and 3/19 normotensive patients (n.s.) had an underlying vascular abnormality). We concluded that there is a significant proportion of relevant underlying vascular abnormalities in patients with BGH. This likelihood is not predicted by risk factors such as hypertension and age. These findings indicate the importance of vascular imaging in patients with BGH who are not neurologically devastated.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Malformações Vasculares/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Malformações Vasculares/diagnóstico , Malformações Vasculares/terapia , Adulto Jovem
14.
J Stroke Cerebrovasc Dis ; 21(8): 905.e5-6, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21757373

RESUMO

Brain microbleeds (BMBs) can be detected on the gradient-echo T2*-weighted magnetic resonance imaging and are considered a risk factor for cognitive impairment and intracerebral hemorrhage. Detailed radiologic findings on the etiology of BMBs and their changes remain scarce. We present a case of subacute change in a BMB in the basal ganglia that mimicked a subacute lacunar infarct. Our findings underscore the need for physicians to be careful to not erroneously diagnose BMBs as lacunar infarctions and prescribe unnecessary antiplatelet medication.


Assuntos
Doença Cerebrovascular dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/diagnóstico , Acidente Vascular Cerebral Lacunar/diagnóstico , Idoso , Anti-Hipertensivos/uso terapêutico , Doença Cerebrovascular dos Gânglios da Base/tratamento farmacológico , Hemorragia dos Gânglios da Base/tratamento farmacológico , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Imagem de Difusão por Ressonância Magnética , Humanos , Masculino , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
J Stroke Cerebrovasc Dis ; 21(8): 907.e1-4, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21903416

RESUMO

Bilaterally progressive tinnitus and hearing impairment occurred in a hypertensive patient shortly after an episode of right ganglionic hemorrhage. Audiometric tests showed a mixed sensorineural and conduction hearing loss. When low-dose gabapentin was administrated for the pre-existing postherpetic thoracic neuralgia, the tinnitus dramatically improved but recurred after discontinuation of the drug. Hearing function did not change. In view of a controversy of gabapentin and tinnitus in previous trials, the findings in this patient support that low-dose gabapentin benefits the subgroup of tinnitus patients with secondary contributing factors, such as stroke.


Assuntos
Aminas/administração & dosagem , Hemorragia dos Gânglios da Base/complicações , Ácidos Cicloexanocarboxílicos/administração & dosagem , Antagonistas de Aminoácidos Excitatórios/administração & dosagem , Neuralgia Pós-Herpética/tratamento farmacológico , Acidente Vascular Cerebral/complicações , Zumbido/tratamento farmacológico , Ácido gama-Aminobutírico/administração & dosagem , Audiometria de Tons Puros , Hemorragia dos Gânglios da Base/diagnóstico , Angiografia Cerebral/métodos , Gabapentina , Perda Auditiva Condutiva-Neurossensorial Mista/diagnóstico , Perda Auditiva Condutiva-Neurossensorial Mista/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/complicações , Acidente Vascular Cerebral/diagnóstico , Zumbido/diagnóstico , Zumbido/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
Peptides ; 32(2): 253-7, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21126545

RESUMO

High plasma copeptin levels are associated with mortality after intracerebral hemorrhage (ICH). However, there is a paucity of data available on whether copeptin is an independent prognostic marker of mortality. Thus, we sought to furthermore evaluate this relation. Thirty healthy controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Its concentration was measured by enzyme-linked immunosorbent assay. After ICH, plasma copeptin level in patients increased during the 6-h period immediately, peaked in 24h, decreased gradually thereafter, and was substantially higher than that in healthy controls during the 7-day period. A multivariate analysis showed plasma copeptin level was an independent predictor for 1-week mortality (odds ratio, 1.013; 95% confidence interval (CI), 1.003-1.023; P=0.009) and positively associated with hematoma volume (t=6.616, P<0.001). A receiver operating characteristic curve identified that a baseline plasma copeptin level >577.5pg/mL predicted 1-week mortality with 87.5% sensitivity and 72.2% specificity (area under curve (AUC), 0.873; 95% CI, 0.784-0.935). The AUC of the copeptin concentration was similar to those of Glasgow Coma Scale (GCS) scores and hematoma volumes (P=0.136 and 0.280). However, copeptin did not statistically significantly improve the AUCs of GCS scores and hematoma volumes (P=0.206 and 0.333). Hence, increased plasma copeptin level is associated with hematoma volume and an independent prognostic marker of mortality after ICH.


Assuntos
Hemorragia dos Gânglios da Base/sangue , Hemorragia dos Gânglios da Base/diagnóstico , Glicopeptídeos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia dos Gânglios da Base/mortalidade , Hemorragia dos Gânglios da Base/patologia , Biomarcadores/sangue , Glicemia/metabolismo , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Sensibilidade e Especificidade , Fatores de Tempo
17.
Acta Neurol Belg ; 111(4): 268-75, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22368965

RESUMO

BACKGROUND: Hypertension-associated intracerebral hemorrhage, when compared with cerebral infarction and subarachnoid hemorrhage, is associated with worse clinical outcomes or major disability. Worse clinical outcomes have been observed in the elderly population though age as a factor influencing physicians' final treatment decision is not well determined. MATERIALS AND METHODS: We studied 199 patients diagnosed with intracerebral hemorrhage (ICD code: ICD-9-CM-431) who visited a tertiary medical center from January 2003 to March 2006. Baseline characteristics, major medical histories (including co-morbidities), vital signs, neurological assessment (evaluated by the Glasgow Coma Scale), location of the hemorrhage, and the amount of hemorrhaging were all included as variables. A multivariate logistic regression model was chosen to evaluate the significant independent factors that could influence the physician's choice of treatment approach. RESULTS: There were totally 110 patients meeting the inclusion criteria for enrollment. We observed that worse neurological function on-arrival (chi2 = 8.57, p = .01) and larger amount of bleeding (chi2 = 9.29, p = .01) were more likely to receive surgery. Multivariate logistic regression revealed that age, neurological function on-arrival, and the amount of hemorrhage were significant independent factors influencing the physicians' treatment decision (all p < .05). CONCLUSION: Age, after adjustment for clinical variables representative of clinical severity, was an important factor in the final therapeutic decision. Our data suggest that a comprehensive evaluation of the patients' on-arrival status may be made and that advanced age should not be a determining factor in the choice of final treatment methods.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/terapia , Comportamento de Escolha , Adulto , Fatores Etários , Idoso , Distribuição de Qui-Quadrado , Feminino , Escala de Coma de Glasgow , Humanos , Classificação Internacional de Doenças , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas , Adulto Jovem
20.
Acta Neurochir Suppl ; 105: 161-4, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19066103

RESUMO

BACKGROUND: Xenon-CT is a quantitive technique for estimating cerebral blood flow. To investigate whether penumbra exists around hematoma, regional cerebral blood flow (ICBF) was measured by Xenon-CT in patients with intracerebral hemorrhage (ICH). METHODS: Xenon-CT was performed on 15 patients with basal ganglia hemorrhage and hematoma volume < 50 mL. rCBF was measured within 36 h of onset and an average of 13 days later by 27-pixel rings in perihematomal area and its enantiomorph in contralateral hemisphere. Penumbra was defined as rCBF 8-20 mL x 100 g(-1) x min(-1). RESULTS: Average ICH volume was 13 +/- 7 mL (6.4-23.7 mL). First rCBF examination was conducted at 21.7 +/- 9.4 h (5-37 h), second rCBF examination was conducted at 13.4 +/- 1.8 days (11-18 days) after onset. Within 36h of onset, mean perihematomal rCBF was 28.4 +/- 7.8 mL x 100 g(-1) x min(-1); contralateral region was 34.2 +/- 12.2 mL x 100 g(-l) x min(-1) (p = 0.11). Average 13 days after onset, mean rCBF close to hematoma was 19.4 +/- 8.1 mL x 100 g(-1) x min(-1); rCBF in contralateral region was 40.1 +/- 11.3 mL x 100 g(-1) x min(-1) (p < 0.0001). rCBF in distal perihematomal region was 27.8 +/- 9.5 mL x 100 g(-1) x min(-1); the difference was significant compared to contralateral region (p = 0.0003). One patient's rCBF in area of edema around hematoma was less than 20 mL x 100 g(-1) x min(-1) at first examination. At second examination, 6 patients had same occurrence in region adjacent to hematoma and 2 patients experienced it in distal perihematomal region. CONCLUSIONS: Reduced perihematomal rCBF was shown after ICH; this phenomenon lasted at least 14 days. A number of ICH patients experienced penumbra around hematoma.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Circulação Cerebrovascular/fisiologia , Hematoma/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Xenônio , Adulto , Idoso , Hemorragia dos Gânglios da Base/complicações , Feminino , Hematoma/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA