Journal of Korean Society of Geriatric Neurosurgery 2017;13(2):59-64.
Published online September 30, 2017.
Prognosis of the Spontaneous Intracerebral Hemorrhage on Basal Ganglia in Elderly Patients over 65 Years of Age
Hee Jin Bae , Jong Il Choi , Chang Hyun Kim , Ho Kook Lee , Jae Gon Moon , Tack Geun Cho
Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
65세 이상 고령 환자에서 기저핵의 자발성 뇌내출혈의 예후
한림대학교 의과대학 강남성심병원 신경외과학교실
Intracerebral hemorrhage (ICH) is a common cause of stroke. Since elder patients usually have medical problems, the surgeon has difficulty to determine the treatment. We have studied the prognosis of spontaneous ICH on basal ganglia in elderly patient.
There were 195 patients over 65 years treated as spontaneous ICH on basal ganglia for 6 years. We analyzed them by comparing the surgery and conservative treatment, retrospectively. The patients were divided into two groups. The group A underwent a surgery while the group B did not. Each group was divided into three subgroups by the initial Glasgow coma scale (GCS) score (Subgroup 1: ≥13, 2: 9-12, 3: ≤8). GCS at discharge and modified Rankin score (mRS) of each group were used as the factors of prognosis.
98 patients were in group A, as 97 were group B. The GCS score at discharge and mRS in group A (10.98 and 2.84) were better than in group B (9.64 and 3.43). In group A1, the GCS score was 14.55 while that of B1 was 12.92. The GCS score and mRS in group A2 (10.51 and 2.84) were better than those of B2 (9.32 and 3.43). However, there was no statistical differences with the GCS score in subgroup 3.
In this study, the surgery seems helping the prognosis better, whereas it does not in the patient with poor mental state (GCS ≤8). When surgeon determines the treatment of spontaneous ICH in elder patient, the initial GCS score might be considered as one of the prognostic factors.
Key Words: Intracerebral hemorrhage, Aged, Surgery, Prognosis

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