Early hemorrhage growth in patients with intracerebral hemorrhage
Early hemorrhage growth in patients with intracerebral hemorrhage
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DOI：
10.1161/01.str.28.1.1
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发表时间：
1997-01-01
期刊：
影响因子：
8.3
通讯作者：
Khoury, J
中科院分区：
文献类型：
--
作者：
Brott, T;Broderick, J;Khoury, J
背景和目的-本研究的目的是前瞻性地确定如何频繁发生脑出血的早期增长，以及这种早期增长是否与早期神经功能恶化。方法我们进行了一项前瞻性的观察性研究，脑出血患者发病3小时内。患者有一个神经系统的评估和CT扫描进行基线，基线后1小时，基线后20 hours after baseline.Results实质性增长的实质出血量发生在26%的103例研究患者之间的基线和1小时的CT扫描。另外12%的患者在1小时和20小时CT扫描之间出现大幅增长。通过基线和1小时格拉斯哥昏迷量表和国立卫生研究院卒中量表评分之间的变化测量，基线和1小时CT扫描之间的出血增长与临床恶化显著相关。没有基线的临床或CT预测出血的增长indicated.Conclusions大量早期出血增长的脑出血患者是常见的，并与神经功能恶化。需要进行随机治疗试验，以确定这种持续出血和频繁神经功能恶化的早期自然史是否可以改善。
Background and Purpose The goal of the present study was to prospectively determine how frequently early growth of intracerebral hemorrhage occurs and whether this early growth is related to early neurological deterioration.Methods We performed a prospective observational study of patients with intracerebral hemorrhage within 3 hours of onset. Patients had a neurological evaluation and CT scan performed at baseline, 1 hour after baseline, and 20 hours after baseline.Results Substantial growth in the volume of parenchymal hemorrhage occurred in 26% of the 103 study patients between the baseline and 1-hour CT scans. An additional 12% of patients had substantial growth between the 1- and 20-hour CT scans. Hemorrhage growth between the baseline and 1-hour CT scans was significantly associated with clinical deterioration, as measured by the change between the baseline and 1-hour Glasgow Coma Scale and National Institutes of Health Stroke Scale scores. No baseline clinical or CT prediction of hemorrhage growth was identified.Conclusions Substantial early hemorrhage growth in patients with intracerebral hemorrhage is common and is associated with neurological deterioration. Randomized treatment trials are needed to determine whether this early natural history of ongoing bleeding and frequent neurological deterioration can be improved.