Original Article

Primary Putaınİnal and Thalamic Hematomas: Clinical-CT Comparisons of 96 Cases

  • Murt Çabalar
  • Sabire Yıldırım

İstanbul Med J 2006;7(4):6-11

Objective:

In this study, we investıgated elinical entities in the cases of putaminal heınatoına (PH) and thalamic hematoma (TH) and elinical relation of prognosis between the dimension of hematoma and intraventricular hemorrhage (NH) in computerized tomography (CT).

Material and Method:

Consecutive 96 patients who have putamen (n=50) and thalamus (n=46) localized hematomas and who were hospitalized wıth the diagnosıs of hemorrhagic stroke were included in the study prospectively. Hematoma localizatıon was performed by using saggital re construction technique with the thick transverse sections of 10 mm with the help of Atlas of Schaltenbrand and Wahren. Hematomas whose dimensıons are sınaller than 20 mm were appreciated as smail, whose dimensions are 20 to 30 mm as medium and whose dimensions are bigger than 30 mm as big hematomas.ln our study, Student-T, Spearman carrelation and Chi-Square distributions were used for statistical analyses.

Findings:

The number of the cases whose hematoma dimension is smaller than 20 mm was 9 in PH (18 %), 24 in TH (52 %). The number of the heınatoınas whose dimension is 21 to 30 mm was 7 in PH ( 14 %) and was 18 in TH (39 %) and the hematomas which have dimension bigger than 30 mm was 34 (68 %) in PH and 4 (8 %) in TH. Among the patients died, the smallest hematoma dimension was 15 mm ın TH, 32 mm in PH. In all cases, the rate of IVH was 41% (39cases), this rate was 24% (12 cases) in PH and 59% (27 cases) in TH. Hematoma dimensions of the cases with NH were 20 to 60 mm in PH, 5 to 42 in TH. The rate of death in the cases of NH was 27% ( 10 cases), 33 % in PH (4 cases) and 22 % (6 cases) in TH. The patients in 74% (71 cases) of all cases survived with different degrees of disabilities and reznaining 26 % (25 cases) patients died. The rate of deathin PH group wasfound 30% (15 cases), 22% (10 cases) in TH.

Result:

This study showed us that there was a meaningful difference between hematoma dimensıon and ventricular penetration and the prognosis between the groups of PH and TH (p<0.05). This condition can be explained with the fact that putarninat hematomas have bigger dimensions and thalamic hematomas are more frequendy penetrate in ventricule.

Keywords: İntracerebral hemorrhage, cranial CT, putamen, thalamus