Stroke, Vol 22, 1530-1533, Copyright © 1991 by American Heart Association
CL Franke, JC van Swieten and J van Gijn
BACKGROUND AND PURPOSE: We investigated the residual abnormalities on
computed tomography in a series of patients with proven intracerebral
hemorrhage to determine whether the type of lesion is related to the site
and size of the initial hematoma. METHODS: In a partially prospective
follow-up study, we studied computed tomographic scans of 42 patients with
spontaneous intracerebral hemorrhage after 2-24 (median 9) months. RESULTS:
Lobar hemorrhages had occurred in 20 patients; the other 22 hemorrhages
were in the basal ganglia or thalamus. No residual lesions were found on
seven scans (17%), despite residual handicap in three of these seven
patients (slight, moderate, and moderately severe). In five cases, the scan
showed only focal atrophy, and in two there were only focal calcifications.
There were six patients with slit-like lesions (only after deep
hemorrhages), 12 with rounded and isolated hypodense areas, and 10 with
rounded hypodense areas connected to the ventricular system. The connection
between the residual lesion and the ventricular system depended to a large
extent on the size of the initial hematoma, but very little on whether it
had initially ruptured into the ventricular system. CONCLUSIONS: A
retrospective diagnosis of cerebral hemorrhage on radiological grounds can
be made with confidence only in a small group of patients with slit-like
lesions in the basal ganglia. This diagnosis is impossible in approximately
one third of cerebral hemorrhages because the abnormalities are aspecific
or have completely disappeared.
ARTICLES
Residual lesions on computed tomography after intracerebral hemorrhage
Department of Neurology, De Wever-Ziekenhuis, Heerlen, The Netherlands.
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