Y. Lampl et al., NEUROLOGICAL AND FUNCTIONAL OUTCOME IN PATIENTS WITH SUPRATENTORIAL HEMORRHAGES - A PROSPECTIVE-STUDY, Stroke, 26(12), 1995, pp. 2249-2253
Background and Purpose A prospective study was performed to evaluate n
eurological and functional outcome after spontaneous supratentorial bl
eeding. The aim of the study was to determine whether clinical or neur
oradiological parameters could predict the outcome of these patients d
uring the first hours of hospitalization. Methods Two hundred seventy-
nine patients-52 with thalamic, 87 with putaminal, and 140 with lobar
hemorrhages-were followed prospectively and examined on admission and
at 2 weeks, 3 months, and 6 months after onset. The patients underwent
clinical (according to the Glasgow Coma Scale) and neuroradiological
examinations on admission and were scored clinically and functionally
(according to Stroke Severity score and Barthel Index) on the follow-u
p periods. Risk factors and the correlation between findings on admiss
ion and the latest clinical and functional results were calculated wit
h the chi(2) test, Pearson correlation test, and Student's t test. Mul
tivariate analysis was calculated with the stepwise regression test. R
esults In all of the bleeding locations, lethal outcome was significan
tly correlated with size of the hematoma (P<.001) and Glasgow Coma Sca
le score on admission (P<.001). Intraventricular blood expansion was f
ound to have a better prognosis in thalamic bleeding (P<.007) and a wo
rse prognosis in lobar hemorrhage (P<.01). The functional outcome afte
r 6 months was directly correlated with the size of the bleeding area
in lobar and putaminal hemorrhages. No correlation was found in thalam
ic bleeding. A worse functional outcome was found in putaminocapsular
bleeding (P=.004) and in patients with ischemic heart disease. A limit
ed better recovery prognosis was found in patients with lobar hematoma
in the temporal lobe (P=-.052). Conclusions The probability of lethal
outcome can be calculated on admission in all patients with supratent
orial bleeding and in correlation with the location and size of the bl
eeding area and level of consciousness. Intraventricular expansion of
blood is a better prognostic factor in thalamic bleeding and a worse o
ne in lobar hematoma. Functional outcome is correlated with size of th
e bleeding area and level of consciousness on admission in putaminal a
nd lobar hemorrhages but has no correlation to thalamic hemorrhage.