Morphoclinical study of intracerebral hemorrhage with subarachnoid effusion

The study is an integrated assessment of clinical, imagistic and morphological parameters in severe intracerebral hemorrhages (ICH) complicated with subarachnoid effusion (SAE).

The studied group had 37 cases of patients with ICH and SAE who were hospitalized in the Emergency County Hospital of Craiova and died during hospitalization. The parameters evaluated were clinical (relation with the seasons, age, sex, arterial blood pressure, the motor deficit, degree of coma and Glasgow score at admission) and morphological (the sites of the intraparenchymal hematoma and SAE, the size of the intraparenchymal hematoma, the presence of the mass effect, and the association of intraventricular effusion). The latter were assessed on CT films and during autopsy.

The presence of SAE as a complication of ICH showed a predilection for cold seasons, especially winter. From the 37 studied cases, 18 were men and 19 women. 51.3% of the patients were in the fourth and fifth life decade. Almost 73% of the patients had third stage arterial hypertension at admission, over 56% motor deficits and almost 49% Glasgow scores lower than 6. The hematomas had huge dimensions as compared to hosting encephalic structures, in lobar sites involving more than one lobe. Other risk factors as mass effect, perilesional edema and intraventricular extension (IVE) were constantly present.

The association of SAE with other independent risk factors such as hypertension, low Glasgow scores, dimensions of hemorrhagic foci, presence of mass effect, perilesional edema and intraventricular extension (IVE) results in the death of patient despite any sustained therapeutical intervention.