PROGRESSION OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE
PROGRESSION OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE
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DOI：
10.1212/wnl.39.11.1509
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发表时间：
1989-11-01
期刊：
影响因子：
9.9
通讯作者：
HOGAN, EL
中科院分区：
文献类型：
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作者：
CHEN, ST;CHEN, SD;HOGAN, EL
高血压脑出血（HICH）通常被认为是单相事件。数小时或数天后最初血肿扩大的情况很少有记录。我们描述了 8 名 HICH 急性期持续出血或再出血患者（5 名男性，3 名女性，年龄 39 至 68 岁）的临床和 CT 表现。丘脑是最常见的出血部位 (6/8)。神经系统状态全部恶化：6 例在 24 小时内恶化，2 例在 5 和 7 天后恶化。在出血扩大之前，持续性高血压很常见（6/8）。第二次CT显示所有病例的血肿大小均明显增加。 4 名患者死亡，4 名患者幸存，但患有严重的神经功能障碍。这些系列研究表明，HICH 可能发生活动性出血或再出血，并表明丘脑出血的风险特别高。我们的结论是，对于选定的患者，HICH 后严格控制高血压可能是合理的。
Hypertensive intracerebral hemorrhage (HICH) is generally considered to be a monophasic event. Enlargement of the initial hematoma after several hours or days has rarely been documented. We describe the clinical and CT findings in 8 patients (5 men, 3 women, aged 39 to 68 years) with continued bleeding or rebleeding during the acute phase of HICH. The thalmaus was the most frequent site of hemorrhage (6/8). The neurologic status deteriorated in all: 6 within 24 hours, and 2 after 5 and 7 days. Persistent hypertension was common (6/8) prior to extension of the hemorrhage. The 2nd CT revealed an obvious increase in hematoma size in all cases. Four patients died and 4 survived with severe neurologic disability. These serial studies indicate that active bleeding or rebleeding can occur in HICH and suggests that the risk is particularly high with thalamic hemorrhage. We conclude that meticulous control of hypertension after HICH may be justified in selected patients.