[Intracerebral hemorrhage and treatment with platelet aggregation inhibitors: study of 21 cases]

INTRODUCTION

The place of platelet antiaggregants in the aetiology of intracerebral hemorrhage (IH) has not been extensively studied.

OBJECTIVE

To analyze the characteristics of IH in patients treated with platelet antiaggregants and the possible clinical and prognostic differences from other primary IH.

PATIENTS AND METHODS

A retrospective study of patients admitted to hospital with primary IH from 1985 to 1997. The cases were IH patients while being treated with platelet antiaggregants. For each case we selected two controls with IH and similar age and IH risk factors. The following data was analyzed: start of clinical condition; type, dose, indication and duration of treatment with antiaggregants; mortality, localization, volume and extension of IH to the ventricles. The last four variables were compared with the control group using the ji squared test (chi 2) and the t student test.

RESULTS

21one patients had a primary IH while being treated with antiaggregants: 20 with salicylates (17 aspirin and 3 riflusal) and one with ticlopidine. The dose of aspirin was 500 mg or less in 90% of the cases. In the group treated with salicylates, this was given for more than 20 months in 90% of the cases. Initially there was no clinical progression in any case. No significant differences were observed between the variable compared, although there was a tendency to greater volume, extension to the ventricles and mortality in the group treated with antiaggregants.

CONCLUSIONS

More studies with larger numbers of patients are necessary to be able to confirm the tendencies observed.

[Auditory changes in spontaneous intracranial hypotension]

Descriptive report dealing with the auditive disturbances of 3 patients with spontaneous intracranial hypotension, disorder typified for orthostatic cephalea without a know ground explaining the descent of the cerebrospinal fluid pressure. The patients presented with hypoacusis, hyperacusis, feeling of plenitude, blockade and ear pressure. The clinical picture is supposed to be linked to a low endolabyrinthine pressure, secondary to an intracranial hypotension. Review of auditive symptoms reported in the bibliography among individuals showing benign intracranial hypertension and intracranial hypotension owing to several causes.