[Sequential changes of the cerebral blood flow in hypertensive putaminal hemorrhages]

This study was designed to investigate the sequential changes of the CBF in hypertensive putaminal hemorrhage and to attempt to correlate these data with the treatment and ADL.

The CBF of 28 patients, aged from 39-70 years-old without any past history of cerebral insult, was measured sequentially from the acute stage by the xenon-enhanced CT method. Regarding treatment, 11 were treated conservatively, while 11 underwent stereotactic aspiration and the remaining 6 had an evacuation of the hematoma by craniotomy.

1. The CBF of the hemisphere, thalamus and cortex progressively decreased until 16 weeks after onset, and then recovered gradually. However, the reduction in the CBF continued until reaching the chronic stage at a 20-40% reduction level on both sides. 2. A negative correlation between the CBF and the hematoma volume was noted and in hematoma over 15ml in volume, the CBF always decreased below a level of 30ml/100g/min. 3. There was no correlation between the CBF and the hematoma extension to the internal capsule. 4. There was a significant correlation between the CBF and ADL. 5. A hematoma measuring less than 15ml should be treated conservatively. 6. In hematoma measuring more than 15ml, stereotactic aspiration proved to be more effective than other therapies not only for the recovery of the CBF but also for ADL.