Assessment of the Prognostic Factors of Hypertensive Intracerebral Hemorrhage

Jibu, Kappukattil Jo (2012) Assessment of the Prognostic Factors of Hypertensive Intracerebral Hemorrhage. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


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INTRODUCTION: Intracerebral Hemorrhage is a serious disease with high mortality and morbidity. Intracerebral hemorrhage (ICH) ranks second among pathologies underlying stroke. (The Incidence is 10-40 per year per lakh population. ICH constitutes about 15% of the total number of strokes. A considerable number of ICH is misdiagnosed as brain infracts resulting in an underestimation of the incidence of ICH in any community. Now more than half of the acute stroke patients are investigated within 3 days resulting in identification of more hemorrhagic strokes. AIM OF THE STUDY: To study the prognostic factors of hypertensive intracerebral hemorrhage. MATERIALS AND METHODS: One hundred cases of hypertensive ICH admitted in the departments of neurology amd general medicine in the haospital were studied from June 2010 to July 2011 and followed up till December 2011. Inclusion criteria: 1. CT scan confirmed intracranial hemorrhages. 2. Hypertension – history, treatment records, evidence of target organ damage – retinopathy and left ventricular hypertrophy (LVH) (clinical & ECG). Exclusion Criteria: · Head trauma, · Intracranial neoplasm, · Aneurysm, · AVM, · Bleeding diathesis. SUMMARY AND CONCLUSIONS: This is a study of 100 patients with CT confirmed hypertensive ICH in whom prognostic value of different variables was assessed. Based on the observations of this study, the following conclusions are made: 1. Among the baseline characteristics, age of the patient, smoking habit, alcohol intake, drug abuse and comorbid state – ischemic heart disease were bad prognostic factors. 2. A low score on Glasgow Coma Scale, a high systolic and diastolic BP, pin point pupils and bilateral extensor plantar response on clinical examination influenced the outcome adversely. 3. The size of hematoma, the presence and severity of edema, intraventricular leak, midline shift and hydrocephalus were predictors of bad outcome. Also, pontine hemorrhage had a bad prognosis and cerebellar haemorrhage a good prognosis. 4. The modifiable prognostic factors are avoidance of smoking, alcohol intake and drugs of abuse and proper control of elevated systolic and diastolic BP. Antiplatelet trialists collaboration: collaboration overview of randomized trials of antiplatelet thereapy.

Item Type: Thesis (Masters)
Additional Information: 16091401
Uncontrolled Keywords: Prognostic Factors, Hypertensive Intracerebral Hemorrhage.
Subjects: MEDICAL > Neurology
Depositing User: Subramani R
Date Deposited: 01 Apr 2021 01:02
Last Modified: 01 Apr 2021 01:02

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