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Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi

Year 2012, Volume: 18 Issue: 3, 169 - 172, 01.04.2012

Abstract

Hypertensive intracerebral hemorrhage (ICH) is usually once in a life event. We aimed to explore the pattern of hemorrhage and outcome of recurrent hypertensive ICH. This prospective, consecutive, case series was conducted at the Sulaimaniya general teaching hospital, Iraq, from June 2008 to April 2012. Survived patients with primary hypertensive ICH were followed-up for a variable time; 4 patients only developed a recurrence. All patients underwent serial non-contrast CT brain scanning on the first and second presentations and after variable intervals. The clinical presentations and their outcomes as well as the sites of the hemorrhages were noted. All patients (n=4) were females and their ages ranged from 58 to 72 years. All of the patients had long-standing hypertension and hypercholesterolemia. The first hemorrhages were distributed equally between the right and left sides of the brain while the recurrent ones were more common on the left side. Three out of 4 recurrences developed contra-laterally while only one was ipsilateral to the first hemorrhage; putamenal-putamenal; thalamic-thalamic; cerebellar-cerebellar; and lobar-thalamic. The interval between recurrences ranged from 54 days to 3 years, 8 months, and 2 days. The functional outcome after the first hemorrhage was relatively good in the majority but the second stroke resulted in prominent neurological dysfunction. Recurrent hypertensive ICH was rare among our patients but resulted in profound neurological functional impairment. Contralateral recurrences dominated the pattern. The thalamus was the target for recurrence in 50% of cases.

References

  • Amin OSM, Rasheed AH, Ahmed SM. Simultaneous intracerebral haemorrhages; which came first, the supra-tentoral or the infra-tentorial one? BMJ Case Reports 2010; doi:10.1136/bcr.03.2010.2805.
  • 2. Amin OSM, Omer RT, Abdullah AA, Ahmed RH, Ahmed O, Ahmed S. Recurrent, sequential, bilateral deep cerebellar hemorrhages. J Med Case Reports 2011;5:360.
  • 3. Weisberg LA, Stazio A, Shamsnia M, Elliott D. Nontraumatic parenchymal brain hemorrhages. Medicine (Baltimore) 1990;69(5):277-95.
  • 4. Douglas MA, Haerer AF. Long-term prognosis of hypertensive intracerebral hemorrhage. Stroke 1982;13:488-91.
  • 5. Richardson JC, Einhorn RW. Primary intracerebral hemorrhage. Clin Neurosurg 1963;9:114-30.
  • 6. Fieschi C, Carolei A, Fiorelli M, et al. Changing prognosis of primary intracerebral hemorrhage: results of a clinical and computed tomographic follow-up study of 104 patients. Stroke 1988;19:192-5.
  • 7. Lee KY, Bae HG, Yun IG. Recurrent intracerebral hemorrhage due to hypertension. Neurosurgery 1990;26:586-90.
  • 8. Maruishi M, Shima T, Okada Y, Nishida M, Yamane K, Okita S. Clinical findings in patients with recurrent intracerebral hemorrhage. Surg Neurol 1995;44:444-9.
  • 9. Hirohata T, Sasaki U, Uozumi T, Ohta M, Shinohara S, Takeda T, et al. Study on recurrence of hypertensive intracerebral hemorrhage. Neurol Med Chir (Tokyo) 1991;31(13):887-91.
  • 10. Marquardsen J. Natural history and prognosis of cerebrovascular disease. In: Ross Russell RW, ed. Vascular Disease of the Central Nervous System. 2nd ed. London, England: Churchill Livingstone, Inc; 1983:25-40.
  • 11. Neau JP, Ingrand P, Couderq C, Rosier MP, Bailbe M, Dumas P, Vandermarcq P, Gil R. Recurrent intracerebral hemorrhage. Neurology 1997;49(1):106-13.
  • 12. Chen ST, Chiang CY, Hsu CY, Lee TH, Tang LM. Recurrent hypertensive intracerebral hemorrhage. Acta Neurol Scand 1995;91(2):128-32.
  • 13. Passero S, Burgalassi L, D'Andrea P, Battistini N. Recurrence of bleeding in patients with primary intracerebral hemorrhage. Stroke 1995;26(7):1189-92.
  • 14. Vinters HV, Gilbert JJ. Cerebral amyloid angiopathy: incidence and complication in the aging brain, II: the distribution of amyloid vascular changes. Stroke 1983;14:924-8.
  • 15. González-Duarte A, Cantú C, Ruíz-Sandoval JL, Barinagarrementeria F. Recurrent primary cerebral hemorrhage: frequency, mechanisms, and prognosis. Stroke 1998;29(9):1802-5.

Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi

Year 2012, Volume: 18 Issue: 3, 169 - 172, 01.04.2012

Abstract

Hipertansif intraserebral kanama (HIK) genellikle yaşam boyunca bir kez görünür. Çalışmamızda ise tekrarlayan HIKın kanama özelliklerini ve prognozunu aydınlatmayı amaçladık. Haziran 2008 ile Nisan 2012 tarihleri arasında Süleymaniye Genel Eğitim ve Araştırma Hastanesi, Irakta çalışma prospektif, ardışık vaka serileri ile sürdürülmüştür. Primer HIK sonrası yaşayan hastalar değişken sürelerde izlendi; sadece 4 hastada tekrarlama görüldü. Tüm hastalara ilk ve ikinci başvurularında ve belirli zaman aralıklarında tarama testi olarak kontrastsız bilgisayarlı beyin tomografisi testi uygulandı. Klinik tabloları, prognozları ile beraber kanama bölgeleri kayıt edildi. Dört hastada kadın idi yaşları 58 ve 72 yıl arasında değişmekteydi. Hastaların hepsinde uzun süreli hipertansiyon ve hiperkolesterolemi öyküsü vardı. İlk kanama odakları beynin sol ve sağ yanlarına eşit dağılmışken, tekrarlayıcı olanlar daha çok sol yandaydı. Üçünün tekrarlayıcı atağı kontro-lateral iken sadece birinin ipsilateral kanama idi; putamenal-putamenal, talamik-talamik, serebellar-serebellar ve lobar-talamik. Tekrarlar arası süre 54 gün ile 3 yıl arasındaydı. Çoğu hastada ilk kanama sonrası fonksiyonel düzelme daha iyiydi ama ikinci inme belirgin nörolojik hasar ile sonuçlandı. Tekrarlayan HIK nadir olmasına rağmen belirgin nörolojik fonksiyonel bozulma ile sonuçlanır. Baskın olan şekil kontro-lateral olandır. Vakaların yarısında talamus hedef organdır.

References

  • Amin OSM, Rasheed AH, Ahmed SM. Simultaneous intracerebral haemorrhages; which came first, the supra-tentoral or the infra-tentorial one? BMJ Case Reports 2010; doi:10.1136/bcr.03.2010.2805.
  • 2. Amin OSM, Omer RT, Abdullah AA, Ahmed RH, Ahmed O, Ahmed S. Recurrent, sequential, bilateral deep cerebellar hemorrhages. J Med Case Reports 2011;5:360.
  • 3. Weisberg LA, Stazio A, Shamsnia M, Elliott D. Nontraumatic parenchymal brain hemorrhages. Medicine (Baltimore) 1990;69(5):277-95.
  • 4. Douglas MA, Haerer AF. Long-term prognosis of hypertensive intracerebral hemorrhage. Stroke 1982;13:488-91.
  • 5. Richardson JC, Einhorn RW. Primary intracerebral hemorrhage. Clin Neurosurg 1963;9:114-30.
  • 6. Fieschi C, Carolei A, Fiorelli M, et al. Changing prognosis of primary intracerebral hemorrhage: results of a clinical and computed tomographic follow-up study of 104 patients. Stroke 1988;19:192-5.
  • 7. Lee KY, Bae HG, Yun IG. Recurrent intracerebral hemorrhage due to hypertension. Neurosurgery 1990;26:586-90.
  • 8. Maruishi M, Shima T, Okada Y, Nishida M, Yamane K, Okita S. Clinical findings in patients with recurrent intracerebral hemorrhage. Surg Neurol 1995;44:444-9.
  • 9. Hirohata T, Sasaki U, Uozumi T, Ohta M, Shinohara S, Takeda T, et al. Study on recurrence of hypertensive intracerebral hemorrhage. Neurol Med Chir (Tokyo) 1991;31(13):887-91.
  • 10. Marquardsen J. Natural history and prognosis of cerebrovascular disease. In: Ross Russell RW, ed. Vascular Disease of the Central Nervous System. 2nd ed. London, England: Churchill Livingstone, Inc; 1983:25-40.
  • 11. Neau JP, Ingrand P, Couderq C, Rosier MP, Bailbe M, Dumas P, Vandermarcq P, Gil R. Recurrent intracerebral hemorrhage. Neurology 1997;49(1):106-13.
  • 12. Chen ST, Chiang CY, Hsu CY, Lee TH, Tang LM. Recurrent hypertensive intracerebral hemorrhage. Acta Neurol Scand 1995;91(2):128-32.
  • 13. Passero S, Burgalassi L, D'Andrea P, Battistini N. Recurrence of bleeding in patients with primary intracerebral hemorrhage. Stroke 1995;26(7):1189-92.
  • 14. Vinters HV, Gilbert JJ. Cerebral amyloid angiopathy: incidence and complication in the aging brain, II: the distribution of amyloid vascular changes. Stroke 1983;14:924-8.
  • 15. González-Duarte A, Cantú C, Ruíz-Sandoval JL, Barinagarrementeria F. Recurrent primary cerebral hemorrhage: frequency, mechanisms, and prognosis. Stroke 1998;29(9):1802-5.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Amin Osama Shukir Muhammed This is me

Hero Muhsen Zangana This is me

Publication Date April 1, 2012
Published in Issue Year 2012 Volume: 18 Issue: 3

Cite

APA Muhammed, A. O. S., & Zangana, H. M. (2012). Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi. Gaziantep Medical Journal, 18(3), 169-172.
AMA Muhammed AOS, Zangana HM. Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi. Gaziantep Medical Journal. April 2012;18(3):169-172.
Chicago Muhammed, Amin Osama Shukir, and Hero Muhsen Zangana. “Tekrarlayan Hipertansif Intraserebral Kanama: Irak’ta Tek Bir Kurumdan Vaka Serisi”. Gaziantep Medical Journal 18, no. 3 (April 2012): 169-72.
EndNote Muhammed AOS, Zangana HM (April 1, 2012) Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi. Gaziantep Medical Journal 18 3 169–172.
IEEE A. O. S. Muhammed and H. M. Zangana, “Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi”, Gaziantep Medical Journal, vol. 18, no. 3, pp. 169–172, 2012.
ISNAD Muhammed, Amin Osama Shukir - Zangana, Hero Muhsen. “Tekrarlayan Hipertansif Intraserebral Kanama: Irak’ta Tek Bir Kurumdan Vaka Serisi”. Gaziantep Medical Journal 18/3 (April 2012), 169-172.
JAMA Muhammed AOS, Zangana HM. Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi. Gaziantep Medical Journal. 2012;18:169–172.
MLA Muhammed, Amin Osama Shukir and Hero Muhsen Zangana. “Tekrarlayan Hipertansif Intraserebral Kanama: Irak’ta Tek Bir Kurumdan Vaka Serisi”. Gaziantep Medical Journal, vol. 18, no. 3, 2012, pp. 169-72.
Vancouver Muhammed AOS, Zangana HM. Tekrarlayan hipertansif intraserebral kanama: Irak’ta tek bir kurumdan vaka serisi. Gaziantep Medical Journal. 2012;18(3):169-72.