방사선학적 출혈양상에 근거한 뇌간출혈의 분류에 따른 임상결과

조원중; 문성호; 이승민; 양재영; 최천식; 주문배

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자료유형: 학술저널

저자정보: 조원중 (성균관대학교 의과대학 강북삼성병원 신경외과학교실) 문성호 (성균관대학교 의과대학 강북삼성병원 신경외과학교실) 이승민 (성균관대학교 의과대학 강북삼성병원 신경외과학교실) 양재영 (성균관대학교 의과대학 강북삼성병원 신경외과학교실) 최천식 (성균관대학교 의과대학 강북삼성병원 신경외과학교실) 주문배 (성균관대학교 의과대학 강북삼성병원 신경외과학교실)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제29권 제2호

발행연도: 2000.1

수록면: 217 - 221 (5page)

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Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n＝7) and diffuse tegmentobasilar hemorrhage(group II, n＝30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

#Brain stem hemorrhage #Focal subependymal hematoma #Diffuse tegmentobasilar hemorrhage

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