Clinical features of multiple spontaneous intracerebral hemorrhages

Abstract

Objective To analyze the clinical features of multiple spontaneous intracerebral hemorrhages (MICH). Methods Conservative therapy, puncture and drainage, hematoma removal and/or decompressive craniectomy were used in the treatment of 630 intracerebral hemorrhage (ICH) patients, who were divided into 2 groups: 30 cases with MICH and another 600 cases with solitary intracerebral hemorrhage (SICH). Three months after onset, modified Rankin Scale (mRS) was used to evaluate the prognosis of all cases. Results Compared with patients in SICH group, the occurrence rate of hypertension > 5 years (P = 0.008), diabetes mellitus (P = 0.024), hypercholesterolemia (P = 0.050) and previous ischemic stroke (P = 0.026) were all significantly higher in MICH group. The mean arterial pressure (MAP) level (P = 0.002) and the incidence of limb movement disorder (P = 0.000) were significantly higher in patients with MICH than those with SICH. Basal ganglia and thalamus were the predilection sites of hematoma (P = 0.001). Patients with MICH had worse prognosis compared to those with SICH 3 months after onset (P = 0.006). Conclusions Hypertension > 5 years, diabetes mellitus, hypercholesterolemia and ischemic stroke were identified to be the pathophysiological basis of MICH in this study. All patients with MICH had more serious clinical manifestations after onset and worse prognosis.

DOI: 10.3969/j.issn.1672-6731.2016.01.008