Progression of mass effect after intracerebral hemorrhage
Progression of mass effect after intracerebral hemorrhage
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DOI：
10.1161/01.str.30.6.1167
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发表时间：
1999-06-01
期刊：
影响因子：
8.3
通讯作者：
Powers, WJ
中科院分区：
文献类型：
--
作者：
Zazulia, AR;Diringer, MN;Powers, WJ
背景和目的--虽然脑梗塞后质量效应的演变有很好的特征，但关于脑出血(ICH)的类似数据很少。我们的目标是确定脑出血后肿块效应进展的时间进程和原因。方法：在我们前瞻性收集的数据库中，确定接受了大于或等于2次CT扫描的自发性幕上脑出血患者。回顾测量松果体和透明隔病变的大小和中线移位，并与临床和CT特征进行相关性分析。中线移位增加的原因由2名独立的观察者确定。结果：76例患者接受了235次扫描，每个患者3.1+/-1.3次。66例首次CT是在脑出血后24小时内获得的。25次扫描在第1天重复，80次在第2天到第7天重复，31次在第8天到第14天重复，24次扫描在脑出血后14天重复。88%的初始扫描出现中线移位。中线移位进展17例：10例发生在早期(0.2~1.7天)，与血肿增大相关；7例发生在晚期(9~21天)，与水肿进展相关。出血越多，肿块效应越严重(P
Background and Purpose-While the evolution of mass effect after cerebral infarction is well characterized, similar data regarding intracerebral hemorrhage (ICH) are scant. Our goal was to determine the time course and cause for progression of mass effect after ICH.Methods-Patients with spontaneous supratentorial ICH who underwent greater than or equal to 2 CT scans were identified in our prospectively collected database. CT lesion size and midline shift of the pineal and septum pellucidum were retrospectively measured and correlated with clinical and CT characteristics. Causes for increased midline shift were determined by 2 independent observers.Results-Seventy-six patients underwent 235 scans (3.1+/-1.3 per patient). Initial CT was obtained within 24 hours of ICH in 66. Twenty-five scans were repeated on day 1, 80 on days 2 through 7, 31 on days 8 through 14, and 24 >14 days after ICH. Midline shift was present on 88% of the initial scans. There were 17 instances of midline shift progression: 10 occurred early (0.2 to 1.7 days) and were associated with hematoma enlargement, and 7 occurred late (9 to 21 days) and were associated with edema progression. Progression of mass effect due to edema occurred with larger hemorrhages (P