Spontaneous Intracerebral Hemorrhage :An institutinal experiences regarding clinical features,outcome and management

Dr Poonia Nemichand; Dr Jain Surendra; Dr Surendra Jain

Volume : IX, Issue : VIII, August - 2020

Spontaneous Intracerebral Hemorrhage :An institutinal experiences regarding clinical features,outcome and management

Dr Poonia Nemichand, Dr Jain Surendra, Dr Surendra Jain

Abstract :

Background Spontaneous intracereal hemorrhage (ICH) is significantaly associated with mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Our article evaluate the clinical symptoms,associated factors and effect of conservative and surgical method on outcome following SICH . Materials and Methods. We retrospectively reviewed records and online data of patients who admitted with ct scan proved SICH IN neurocare hospital jaipur between 1st January 2017 and 31st December 2019 . we analysed following indicator – demographic profile , associated comorbidities, Glasgow coma score (GCS) on admission, CT finding, ICH score ,treatment modality and outcome at six months. Modified Rankin score (mRS) was used to assess the outcome at discharge and six months. Results. In our study group of 76 patients included 42 males and 34 females and the mean age at presentation was 63.20 years. In our study 58 patients (76.3%) were previously diagnosed hypertensive, of whom 32 ( 42.10%) were on hypertensive medication. the most common site of hematoma were capsuloganglionic thalamic region (61.84%,n = 47) followed by lobar (30.26% , n = 23), cerebellar (5.2%, n = 4), ainstem (2.63% ,n = 2). 21(27.63%) patients hadintraventricular haemorrhage . 47 patients out of 76 were operated and remaining were managed conservatively In our study 34 (44.73 %) patients died during 6 month follow up periods. death ratio almost same in both mode of treatment .44.82% death occured in conservative and 44.68% death occured after surgery. Among 42 survivors at six months ,11 (14.47%) patients had poor outcome (mRS 4-5) and 31(40.78 %) patients had a favourable outcome (mRS <3). Conclusions. SICH mainly affects a older population (>60 years). Age > 70 years, GCS < 8 on admission, clot volume above 30 ml, intraventricular extension and hydrocephalus predictors were associated with poor outcome and death . In case of moderate to large hematomas Mortality and morbidity can be reduced by surgical evacuation of the clot alone or combined with DC and small size hematoma can be managed conservatively.