SPECTRUM OF PRIMARY INTRACEREBRAL HEMORRHAGE IN PERTH, WESTERN-AUSTRALIA, 1989-90 - INCIDENCE AND OUTCOME
SPECTRUM OF PRIMARY INTRACEREBRAL HEMORRHAGE IN PERTH, WESTERN-AUSTRALIA, 1989-90 - INCIDENCE AND OUTCOME
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DOI：
10.1136/jnnp.57.8.936
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发表时间：
1994-08-01
影响因子：
11
通讯作者：
JAMROZIK, KD
中科院分区：
文献类型：
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作者：
ANDERSON, CS;CHAKERA, TMH;JAMROZIK, KD
在西澳大利亚州珀斯编制的一份基于人群的中风登记(n=536)中，在1989年至1990年的18个月期间，在56人(52%男性)中发现了60例(11%)原发性脑出血。这些患者的平均年龄为68岁(范围23-93岁)，46例(77%)为首次中风。年粗发病率为35/10万，以80年代为高峰，以男性为主。深部和肺叶出血各占所有病例的近三分之一。临床表现包括突然昏迷(12%)、头痛(8%)、癫痫发作(8%)和单纯感觉-运动性中风(3%)。2例(均致命)首次表现为原发性脑内出血，4例为酗酒后出现。55%有高血压病史。16名患者(27%)，其中一半有高血压病史，正在服用抗血小板药物，1名患者正在服用华法林。只有两个确诊的淀粉样血管病病例。总的28天病死率为35%，但脑干出血的病死率为100%，基底节区或丘脑区的病死率为22%。早期死亡的其他预测因素包括脑室内血肿扩张、血肿体积、肿块效应、发病时昏迷和严重瘫痪。尽管基于少量数据，这些数据证实了原发性脑出血的异质性，但它们也表明，与神经科专科病房的经验相比，社区中这种类型的中风有不同的临床谱系。
In a population based register of stroke (n = 536) compiled in Perth, Western Australia during an 18 month period in 1989-90, 60 cases (11%) of primary intracerebral haemorrhage were identified among 56 persons (52% men). The mean age of these patients was 68 (range 23-93) and 46 (77%) events were first ever strokes. The crude annual incidence was 35 per 100 000, with a peak in the eighth decade, and a male predominance. Deep and lobar haemorrhages each accounted for almost one third of all cases. The clinical presentations included sudden coma (12%), headache (8%), seizures (8%), and pure sensory-motor stroke (3%). Primary intracerebral haemorrhage was the first presentation of leukaemia in two cases (both fatal) and it followed an alcoholic binge in four cases. 55% had a history of hypertension. 16 (27%) patients, half of whom had a history of hypertension, were taking antiplatelet agents, and one patient was taking warfarin. There were only two confirmed cases of amyloid angiopathy. The overall 28 day case fatality was 35%, but this varied from 100% for haemorrhages in the brainstem to 22% for those in the basal ganglionic or thalamic region. Other predictors of early death were intraventricular extension of blood, volume of haematoma, mass effect, and coma and severe paresis at onset. Although based on small numbers, these data confirm the heterogeneous nature of primary intracerebral haemorrhage, but they also suggest a different clinical spectrum of this type of stroke in the community compared with the experience of specialist neurological units.