Spontaneous Intracerebral Hemorrhage in Northeast Malaysian Patients: A Four-Year Study

Abstract

The aim of this study was to compare nonsurgical versus stereotactic aspiration of intracerebral hematomas in relation to clinical aspects, computed tomographic imaging features of the brain, laboratory parameters and specific risk factors that may influence the outcome in southeast Asian Malay patients. Fifty-five of the patients with intracerebral hemorrhage (ICH) underwent stereotactic aspiration and 57 did not. Analysis was done on risk factors, locations and treatments of ICH, and the final outcomes measured by the Glasgow Outcome Scale. A total of 112 patients were evaluated. Mean age was 52 years with ages ranging from 12 to 80 years. Hypertension was seen in 60.7% of patients with ICH. The mortality rate was 25% by 3 months. 58.9% had a poor final outcome, while 41.1% had a good outcome. The selected variables were incorporated into models generated by multiple logistic regression method analysis to define the significant predictors of outcome. Significant predictors of outcome were the Glasgow Coma Scale score on admission, the duration of surgery and the total volume of the hematoma. Significant predictors of mortality were high total white blood cell differential count, low plasma protein, and high plasma lactate dehydrogenase and brain edema. The study suggests that stereotactic aspiration of patients with ICH does not offer any definite advantage over conservative treatment.

Risk Factors Associated with Outcome of Spontaneous Intracerebral Haemorrhage: Hospital Kuala Lumpur Experience

“…Although the data in this study showed non-statistical significance for mortality, the impact of disability-adjusted life years (DALY) is unarguable as the younger Malaysian population is developing ICH in Malaysia. Age was of no significance in predicting mortality ( P = 0.739) in this study, which was a similar finding from other studies ( 12 , 13 ).…”

Modifying the details of aspiration operation may contribute to the improvement of prognosis of patients with ICH

“…GOS and BI (the follow-up time was 122 weeks) was 4 and 90 respectively. ) were relatively larger than that of many other studies (8,14,23), the total rate of mortality was low (15.7%).…”

Three-dimensional reconstructed CT scanning for targeting hypertensive putaminal hemorrhage

“…12 Alternative surgical procedures include craniotomy, endoscopic surgery and stereotactic aspiration, and various outcomes have been reported. 13,14 Minimally invasive techniques and early surgical intervention may be good options for patients with a significant volume of HPH. 4 The 3D reconstructed CT scan imaging technique could serve as a time-saving, simple, economic, and accurate method for targeting HPH, with no additional CT scanning needed thereafter for surgical planning.…”