[Practical CT classification for thalamic hemorrhage: relationship between localization of hematoma and prognosis]

It is not easy to predict functional outcome in patients with acute-stage thalamic hemorrhage. We analysed 100 cases of hypertensive thalamic hemorrhage less than 4 cm in diameter, and devised a practical CT classification for predicting the patients' prognoses. On an axial CT scan at the level of the pineal body, four lines were drawn as follows: line (a) between the lateral edge of the anterior horn and the midpoint of the third ventricle; line (b) vertical line to the sagittal line from the midpoint of the third ventricle; line (c) between the lateral edge of the trigone and the midpoint of the third ventricle; line (d) between the lateral edge of the anterior horn and the lateral edge of the trigone. The location of hematoma was divided into three types according to lateral extension as follows: type A (anterior type), center of hematoma located between line (a) and line (b); type P (posterior type), center of hematoma located between line (b) and line (c), and external margin of hematoma localized medial to line (d); type PL (postero-lateral type), center of hematoma located between line (b) and line (c), and showing lateral extension beyond line (d). Then, the correlation between hematoma location and severity of motor paresis at onset and its prognosis was investigated. Severe hemiparesis (MMT: 0-2) was observed in 15.3% of patients with type A, 21.8% with type P, and 59.3% with type PL hematoma in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)