Postoperative Brainstem High Intensity Is Correlated with Poor Outcomes for Patients with Spontaneous Cerebellar Hemorrhage

Postoperative Brainstem High Intensity Is Correlated with Poor Outcomes for Patients with... AbstractOBJECTIVE:The outcomes for patients with cerebellar hemorrhage are thought to be influenced by anatomic damage to the brainstem. In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cerebellar hemorrhage who are in poor-grade condition.METHODS:The results for 31 patients with spontaneous cerebellar hemorrhage, with Glasgow Coma Scale scores of 8 or less at admission, who underwent magnetic resonance imaging examinations were reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their Glasgow Outcome Scale scores at the time of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (Group I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (Group II, n = 23). We investigated obliteration of the fourth ventricle and the perimesencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images.RESULTS:Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 32.3%. There were no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in the pons and midbrain in T2-weighted images for Group II was significantly higher than that for Group I (P < 0.01).CONCLUSION:Magnetic resonance imaging clearly demonstrated brainstem damage, and high signal intensity in the brainstem was a significant prognostic factor for determining outcomes for patients with spontaneous cerebellar hemorrhage who were in poor-grade condition. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Postoperative Brainstem High Intensity Is Correlated with Poor Outcomes for Patients with Spontaneous Cerebellar Hemorrhage

Postoperative Brainstem High Intensity Is Correlated with Poor Outcomes for Patients with Spontaneous Cerebellar Hemorrhage

C L I N I C A L S T U D I E S Postoperative Brainstem High Intensity Is Correlated with Poor Outcomes for Patients with Spontaneous Cerebellar Hemorrhage Kiyoyuki Yanaka, M.D., Ph.D., Kotoo Meguro, M.D., Keishi Fujita, M.D., Kiyoshi Narushima, M.D., Tadao Nose, M.D., Ph.D. Department of Neurosurgery (KY, KM, KF, KN), Tsukuba Medical Center, and Department of Neurosurgery (TN), Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan OBJECTIVE: The outcom es for patients w ith cerebellar hemorrhage are thought to be influenced by anatom ic damage to the brainstem . In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cereb ellar hem orrhage who are in poor-grade condition. METHODS: The results for 31 patients w ith spontaneous cerebellar hemorrhage, w ith Glasgow Coma Scale scores of 8 or less at admission, w ho underwent magnetic resonance imaging examinations w ere reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their Glasgow O utcom e Scale scores at the tim e of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (G roup I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (G ro up II, n = 23). W e investigated obliteration of the fourth ventricle and the perim esencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images. RESULTS: Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 3 2 .3 % . There w ere no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199912000-00010
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:The outcomes for patients with cerebellar hemorrhage are thought to be influenced by anatomic damage to the brainstem. In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cerebellar hemorrhage who are in poor-grade condition.METHODS:The results for 31 patients with spontaneous cerebellar hemorrhage, with Glasgow Coma Scale scores of 8 or less at admission, who underwent magnetic resonance imaging examinations were reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their Glasgow Outcome Scale scores at the time of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (Group I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (Group II, n = 23). We investigated obliteration of the fourth ventricle and the perimesencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images.RESULTS:Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 32.3%. There were no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in the pons and midbrain in T2-weighted images for Group II was significantly higher than that for Group I (P < 0.01).CONCLUSION:Magnetic resonance imaging clearly demonstrated brainstem damage, and high signal intensity in the brainstem was a significant prognostic factor for determining outcomes for patients with spontaneous cerebellar hemorrhage who were in poor-grade condition.

Journal

NeurosurgeryOxford University Press

Published: Dec 1, 1999

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