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Bilateral simultaneous hypertensive intracerebral hemorrhages
1Department of Surgery, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi = the Kaohsiung Journal of Medical Sciences
|May 1, 1993
Summary
Bilateral simultaneous hypertensive intracerebral hemorrhages (HICH) are rare but severe. This study found that surgical intervention for HICH yielded poor outcomes, with non-surgical cases also resulting in high mortality or significant disability.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Bilateral simultaneous hypertensive intracerebral hemorrhages (HICH) are uncommon and clinically challenging.
- Computed tomography (CT) is crucial for diagnosing this condition.
Purpose of the Study:
- To investigate the clinical characteristics, outcomes, and prognosis of bilateral simultaneous HICH.
- To compare the outcomes of surgical versus non-surgical management in these rare cases.
Main Methods:
- Retrospective analysis of 553 HICH cases, identifying 6 patients (2.6%) with bilateral simultaneous hemorrhages.
- Clinical data and CT findings were reviewed.
- Outcomes of surgical evacuation and non-surgical management were assessed.
Main Results:
- Six patients (4 males, 2 females; age 54-64) presented with severe symptoms including consciousness disturbance, aphasia, and bilateral paresis.
- Hematomas were located in basal ganglia, thalamus, pons, and occipital lobes, often rupturing into ventricles.
- Surgical evacuation resulted in early mortality; non-surgical cases had high mortality or severe sequelae (hemiplegia).
Conclusions:
- Bilateral simultaneous HICH carries a grave prognosis, with both surgical and non-surgical approaches offering limited success.
- Poor cerebral blood flow and diaschisis may contribute to the adverse outcomes.
- Further research into optimal management strategies for this rare condition is warranted.