[Computed tomographic (CT) findings in cases of putaminal hemorrhages with hemiplegia that have taken a favorable course (author's transl)]

Hypertensive putaminal hemorrhage: treatment and results. Is surgical treatment superior to conservative one?

Seventy-four patients with hypertensive putaminal hemorrhage (HPH) were followed at least 6 months after treatment and estimated by ADL. They were graded according to the state of consciousness on admission. The grading consists of 6 grades: Grade 1, fully conscious; Grade 2, somnolent; Grade 3, stuporous; Grade 4, semi-comatose; and Grade 5, deeply comatose. Removal of HPH was performed in 18 patients and conservative treatment was done in 56 patients. The mortality in surgically treated group was 28% while that in conservatively treated group was 14%. The patients who returned to full work or independent life without disability and with minimal disability after surgical treatment were, 50% in Grade 1, 33% in Grade 2, and 50% in Grade 3. The patients without disability and with minimal disability after conservative treatment were; 87% in Grade 1, 80% in Grade 2, and 22% in Grade 3. None below Grade 4 returned to full work or independent life in both groups. There was good correlation between the state of consciousness and CT findings on admission. There was no correlation between good recovery and the side of HPH. Our results do not support the view that the surgical treatment is superior to the conservative one in the management of HPH.

[CT differential diagnosis and findings in intracerebral haemorrhage (author's transl)]

The CT findings of 73 patients with spontaneous and traumatic intracerebral haematomas are described. The course and pattern of resorption of the bleeding is evaluated. It is shown that the resorption of all haematomas is terminated by the end of week 7 independent of their maximum diameter. Only smaller haemorrhage of less than 2 cm can be resorbed in a shorter time. Moreover, the underlying pathophysiologic mechanisms of faster resorption of bleeding located in the basal ganglia and the neighbouring white matter are discussed. The CT findings revealed no clear-cut characteristics for differential diagnosis of the etiology of haematomas, but proved very helpful in defining the prognosis.