[On the intracerebral hematoma --clinical analysis of 105 operated cases-- (author's transl)]

Abstract

The hematomas occupied between the inner surface of skull and brain surface are well known and the majority of these intracranial hematomas are elicited by head injury. On the other hand, the intracerebral hematomas formed in the brain tissue are produced by the various causative diseases and the majority of these cause are cerebrovascular disease. The causative diseases of intracerebral hematomas were cerebrovascular diseases like hypertension, intracranial aneurysm and cerebral arteriovenous malformation in 65.7% and head injury in 32.4%. The cause of two cases were bleeding from asymptomatic brain tumors and formation of intracerebral hematoma produced initial clinical symptom of these cases. Age distribution of intracerebral hematoma has peculiarity in each causative disease. Hypertensive intracerebral hematomas occurred in patients over 30 years old and intracerebral hematoma due to bleeding from cerebral arteriovenous malformation was not observed in patient over 50 years old. The frequency of consciousness change as initial symptom of traumatic intracerebral hematome, hypertensive intracerebral hematome, intracerebral hematoma caused by bleeding from cerebral arteriovenous malformation and bleeding from intracranial aneurysm and spontane intracerebral hematome are 79.4%, 57.1%, 57.1%, 40.0% and 25.0% respectively. Headache as initial symptom are conspicuous in patients of intracerebral hematoma caused by bleeding from intracranial aneurysm and arteriovenous malformation, and each frequency were 86.7% and 71.4%. The frequency of motor disturbance as initial symptom was highest in patients of hypertensive intracerebral hematoma and its frequency was 50.0%. Clinical symptoms observed at admission were as follows: Consciousness change in patients of hypertensive intracerebral hematoma and traumatic intracerebral hematoma were 100% but in patients of cerebral arteriovenous malformation and intracranial aneurysm were 64.3% and 60.0%. Consciousness change in patients of spontane intracerebral hematoma were only 50.0%. Motor disturbance as clinical symptom were 85.0% in hypertensive intracerebral hematoma and this frequency was highest in all causative diseases. The frequency of coincidence between the side of dilated pupil under anisocoria and the side of hematoma was less than 50.0% in average and this frequency was marked lower by compared with the frequency in patients of hematome formed between the skull and brain surface.