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Category: Volume 05 Issue 08 August 2017
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Title: Prognostic factors in Spontaneous Hypertensive Intracerebral Hemorrhage

Authors: Dr Ranjit Sanu Watson, Dr Aruna, Dr Wilson Joseph, Dr Sabarisree M

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.11

Abstract

Background: Stroke is a major cause of death and disability. Haemorrhagic strokes constitute 20% of all strokes. Most important risk factor for development of spontaneous intracerebral haemorrhage is systemic hypertension.

Objectives: To study the different clinical and radiologic factors which can be considered as prognostic markers and predictors of survival in patients with spontaneous hypertensive intracerebral hemorrhage.

Materials and Methods: The study is a prospective descriptive study of 100 consecutive patients meeting the inclusion criteria for spontaneous hypertensive intracerebral hemorrhage admitted in the medical wards of a tertiary care centre, Gov. Medical college, Thiruvananthapuram, Kerala. The study was conducted over a period of one year. The patients were clinically assessed and radiologic findings noted.

Results: Older age, presence of headache, vomiting and altered level of consciousness, high systolic BP on admission, long standing hypertension, irregularities in respiration, low GCS on admission, bilateral extensor plantar response, progressive worsening of sensorium , aspiration pneumonia,  larger volume of hematoma, presence of  intraventricular extension,  hydrocephalus,  midline shift and mass effect correlated closely with poor   outcome and higher mortality.

Conclusions: A low Glasgow coma score on admission, respiratory irregularity, anisocoria, large volume hemorrhage, presence of intraventricular extension and hydrocephalus are statistically significant prognostic markers in patients with spontaneous hypertensive intracerebral hemorrhage.

Keywords: Hypertension, Intracerebral hemorrhage, Stroke.

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Corresponding Author

Dr Sabarisree M

Associate Professor (CAP) in Orthopaedics,

Govt Medical College, Trivandrum