Abstract Details

Title Does Location Matter? Thalamic Versus Capsular-Ganglionic Hypertensive Hemorrhages

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 067

Objective

Background BACKGROUND: Patients' age, hematoma size and examination on presentation are among the well known predictors of outcome in intracerebral hemorrhage (ICH). We sought to study the effect of hematoma location, which to our knowledge has not garnered much attention, on outcome.

Design/Methods DESIGN/METHODS: We reviewed a database of patients with spontaneous ICH admitted between January 2009 and June 2012. We determined the location of hematoma and calculated its volume using Philips Brilliant Workspace software on admission CT scan. We excluded lobar and posterior fossa hemorrhages. We divided patients into two groups based on hematoma location: thalamic vs. capsular-ganglionic. We reviewed the dataset for demographic and baseline characteristics. We used Fisher's exact test to compare clinical, laboratory, and imaging parameters, and in-hospital mortality between the groups. We defined poor discharge outcome as in-hospital death or discharge to nursing home.

Results RESULTS: We identified 198 patients with spontaneous ICH; 44 had thalamic and 70 had capsular-ganglionic hemorrhages. Although baseline characteristics including hematoma size, expansion rate, hydrocephalus, other comorbidities, and intubation rates were similar between the groups, patients with thalamic hemorrhages were more likely to require a tracheostomy (11% vs. 1%, p=0.032), had longer ICU (7 ± 9 days vs. 4 ± 4 days, p=0.038), and overall hospital stay (12 ± 13 days vs. 8 ± 7 days, p=0.045). Poor outcome was similar between the two groups (50% vs. 37%, p=0.177). Patients with thalamic hemorrhages only showed a trend for a higher incidence of complications like pneumonia, urinary tract infection and deep venous thrombosis.

Conclusions CONCLUSIONS: Patients with thalamic hemorrhage have longer ICU and hospital stays, but show only a trend toward poor discharge outcome. Establishing a new scoring system that incorporates thalamic location of hemorrhage could be helpful in our efforts to prognosticate.

Authors/Disclosures
Anand V. Patel, MD (University of Texas Medical Branch) PRESENTER	Dr. Patel has nothing to disclose.
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.
Jamil R. Dibu, MD (Cleveland Clinic Abu Dhabi)	No disclosure on file
Archana Hinduja, MD	Dr. Hinduja has nothing to disclose.
	No disclosure on file
Eugene Y. Achi, MD (Cleveland Clinic Abu Dhabi)	No disclosure on file
	No disclosure on file
Salah G. Keyrouz, MD (WUSM)	No disclosure on file

��ɫ��

��ɫ��