Factores de prognóstico nas hemorragias cerebrais intraparenquimatosas. Análise de uma série de internamento hospitalar.

Resumo

We studied 76 patients, with the diagnosis of spontaneous intracerebral haematoma confirmed by CT scan, admitted to the Internal Medicine Department of S. Pedro Hospital, Vila Real, from 1991 to 93. Neurologic examination, radiological characteristics, previous diseases, clinical evolution and treatment were analysed to select prognostic factors in relation to length of stay, functional status and mortality. Length of stay varied between 1 and 63 days and it is estimated that 50% of these patients have a length of stay of less than 22 days. In what concerns length of stay, the localisation of haematoma (p < 0.001) and presence/absence of systemic infections (p < 0.001) were the most significant prognostic factors. The haematomas localised in the brain stem or cerebral deep massive and the occurrence of systemic complications were associated to a longer hospital stay. None of the parameters analysed were related to functional status (Rankin scale), despite the fact that functional impairment was present in 57.1% of the patients whose hemorrhage had ventricular blood, compared with 27.5% whose hemorrhage had no ventricular blood. In this series, the mortality rate was 29.2% and the presence/absence of ventricular blood was the most important prognostic factor (p < 0.001). The mortality rate in patients whose haematoma presented ventricular blood was five times higher than in the remainder.