Primary non traumatic intracranial hemorrhage: 139 consecutive cases treated at an emergency regional hospital

We review 139 consecutive cases of primary non-traumatic intracranial hemorrhage observed at the Neurosurgical Division of Pellegrini Hospitals, Naples. We excluded 20 similar cases which were not thoroughly studied. In the region Campania, which has almost five and a half million inhabitants, there are four emergency centres for neurosurgical patients one of which is at the Pellegrini Hospitals in Naples. In our series of 139 patients, 68 (48.92%) had an intracerebral hematoma (CH); while 71 (51.07%) patients had a subarachnoid hemorrhage (SAH). Thirteen cases out of 68 were added to the 71 cases with SAH because they had an arterial aneurysm or an arteriovenous malformation (AVM) which had ruptured both in the subarachnoid space and in the brain. The most frequent cause of CH was arterial hypertension. Out of 84 patients with SAH, 57 (67.85%) had a vascular malformation. Age, sex, presence of vasospasm, gravity of hemorrhage and interval between hemorrhage and neurosurgical observation were studied. Out of 139 cases, 68 (48.92%) were surgically treated. In conclusion, out of 68 operated patients, 48 (70.58%) survived and 20 died; while, out of 71 non-operated patients, 24 (23.80%) survived and 47 died. The survival rate of patients with aneurysms operated on after 14 days from the hemorrhage is 90.47%. The survival rate in patients with CH operated on after the fifth day is 89.47%.