| Prognostic Factors According to the Location of the Primary Pontine Hemorrhage with Schematic Classification System |
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Do-Yeon Kim , Byung-Sup Kim , Jae-Young Choi , Jong-Yeol Kim , Jung-Hyun Park , Hyuk-Rae Cho , Yong-Seok Park |
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Department of Neurosurgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea |
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| Abstract |
Objective
Primary pontine hemorrhage is very fatal, but the prognosis of the patients is different from the factors that the patients have. As such, the prognosis was analyzed using the location, volume, and invasion area of the hemorrhage based on the CT scans, and the other prognostic factors that the patients might have were also analyzed.
Methods
Thirty seven patients who have been diagnosed with primary pontine hemorrhage were retrospectively analyzed. Based on anatomical classification, the hemorrhage was divided into four types: the massive, bilateral tegmental, tegmento-basilar, and unilateral types. Based on schematic classification, it was also divided into five types: the all-quadrant, central, lateral, ventral, and dorsal types.
Results
Twenty one (57%) of the 37 patients survived, and 16 patients (43%) died. Based on anatomical classification, the massive type showed a significantly low survival rate (0%, p<0.001). Based on schematic classification, the all-quadrant type showed low GCS (4.8±1.2, p=0.02) with a great volume (16.5±7.7, p=0.03), a greater rate of extension to the midbrain or thalamus(55.6%, p=0.03) and into the ventricle (88.9%, p<0.001), and a low survival rate (0%, p<0.001). Additionally, the survival rate of the central type was lower than that of the other types (42.9%, p<0.001).
Conclusion
As the diagnosis using a CT scan is essential in primary pontine hemorrhage, the fast classification of the patients based on the CT scan can help medical professionals establish a treatment plan. In this study, the massive, all-quadrant, and central types showed poor prognoses whereas the other types had relatively good prognosis. |
| Key Words:
Pontine hemorrhageㆍPrognosisㆍComputed tomographyㆍPredictor |
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