고혈압성 뇌실질내 혈종의 급성 팽창
Acute Expansion of Hematoma in Hypertensive Intracerebral Hemorrhage
대한뇌혈관학회지 2001년 3권 2호 p.163 ~ 168
소속 상세정보
문창택/Chang Taek Moon
임성준/윤승환/조준/장상근/Sung Joon Lim/Seung Hwan Yoon/Joon Cho/Sang Keun Chang
KMID : 0890520010030020163
Abstract
Hypertensive intracerebral hemorrhage is one of the most common cause of death in Korea and usually considered as a monophasic event. But recently acute expansion of the hematoma within an hour to a day, has been reported as a cause of severe
neurological deterioration and death. To know the incidence and risk factors of acute expansion of the hematoma in hypertensive intracerebral hemorrhage, the authors retrospectively analysed 96 hypertensive intracerebral hemorrhage patients who
were
admitted to Minjoong hospital from January 1997 to December 1998. neurological examination with Glasgow Coma Scale and first computed tomography (CT) scan were performed as soon as possible after arrival. Then second CT scan was performed within
an
hour
to a day before the operation. Blood sample was taken within an hour for routine laboratory examination including liver function and coagulation test. The amount and shape was taken within an hour for routine laboratory examination including
liver
function and coagulation test. The amount and shape of hematoma on CT scans were carefully measured to know whether acute expansion was occurred or not. The patients who have acute expansion of the hematoma were 15 patients (15.6%). Expansion of
the
hematoma was not correlated with sex, age, site, shape, or amount of hematoma statistically. But thalamic hematoma in location, irregular shape of hematoma, or large amount of hematoma has a tendecy of acute expansion. The time of onset to
arrival,
initial systolic pressure, liver dysfunction and history of heavy alcohol drinking were correlated with acute expansion statistically (p<0.05). The shorter the time of onset to arrival and the higher initial systolic pressure, the more the
incidence of
acute expansion of the hematoma significantly. Acute expansion of the hematoma was significantly increased with the severity of liver dysfunction and history of heavy alcohol drinking. The levels of glutamic oxaloacetic transaminase (GOT),
alkaline
phosphatase, gamma-glutamyl transpeptidase (γ-GTP) and platelet (PLT) count were meaningful indices of hematoma expansion.
키워드
급성 팽창; 고혈압성 뇌출혈; 간기능; 알코올; Acute expansion; Intracerebral hemorrhage; Hematoma; Liver dysfunction; Hematoma shape and amount;
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