الفهرس 
Material and methodsOnly 14 pages are availabe for public view
 |  | from | 196 |  |  |
| | | from | 196 | | |
Abstract
Strokes is the most common senous neurological condition in
clinical practice it is the third leading cause of death throughout the
industrialized world, after heart disease and cancer.
The aim of this study is to answer in a more or less definite
scientific and if possible measurable way the questions raised by the
patient and family about prognosis and prognostic factor of intracerebral
hemorrhage.
In this study we included prospectively (100) patients with
hemorrhagic strokes, 48 of them were males and 52 of them were
females within the 151 30 hours from onset.
Their ages varied from 25 years to above 65 years old. 58 cases
live in rural area and 42 cases in urban areas.
All patients subjected to full general physical examination, full
neurological examination, neurological assessment on arrival using the
following scales, Glasgow coma scale, Mini-mental state, Canadian
neurological scales and National institute of health (NIH) scale.
All patient were tested for the following blood glucose level, red
blood corpuscles, platelet count, white blood corpuscles, hematocrit,
cholesterol triglycerides, blood urea and serum creatinine.
All patients were subjected to CAT scan to define the etiology.
Follow up assessment were attempted on all living at out-patient
clinic in Benha university hospital or at patients home twelve months
after the onset. Functional outcome after one year assessed by the
-- -- --- - ---- --- --- - - --- --- ------- ------ - ---
SUMMA/?Y
following scales. Motoricity index, Functional ambulating categories,
Barthel ADL scale, 4 Point scale.
Regarding to the aetiology : Hypertension was the most prevalent a
etiological factors for intracerebral hemorrhage and it was responsible
for large percent of our cases , followed by ruptured aneurysm ,
anticoagulant then vasculitis . In this study inspite of all investigations
performed we could not reach to a proper aetiology in 29.0 % of cases.
Regarding to the risk factors: This study showed that hypertension was
the first and most important risk factors followed by aspirin and non
steriodal anti-inflammatory, stress factor, obesity, smoking, diabetes,
cardiac cases , oral contraceptive pilles then alcohol. There was
statistically significant difference between both groups males and
females regarding smoking, obesity and oral contraceptive pilles .
Regarding to the prognosis :This study showed that 16.0 % of our
patients had a good prognosis, 28.0 % had a moderate prognosis and
56.0 % had a worse prognosis.
Regarding to age : Our results concluded that the older the patient
including in this study the worse was the prognosis and we consider age
one of the prognostic factors in hemorrhagic strokes.
Regarding to the sex: There was no statistically significant differences
between males and females in relation to prognosis.
Regarding to the residence: Our study concluded that residence is one
of the prognostic factors in long term outcome.
Regarding to the level of consciousness: our results concluded that the
prognosis was related to deteriorating level of consciousness and the
=======--r’[ ’=l15050~1DJ=========
-- ~~- -- - - -~- -- - ----
SU/I,fMA /I r
level of consciousness represent the most important predictor of outcome
(short term outcome and long term outcome).
Regarding to the use of mechanical ventilation: We concluded that the
use of mechanical ventilation is one of the prognostic factors in
hemorrhagic strokes.
Regarding to the relation between brain oedema and mass effect: This
study found that brain oedema is an important cause of mass effect in
intracerebral hemorrhage and it is one the predictors of outcome.
Regarding to intraventricular hemorrhage: Our results fount that the
presence of intraventricular hemorrhage as one of the predictor of
outcome and it leads to large number of cases with worse prognosis.
Regarding to the site of treatments: In this study we found that cases
treated III general medical words carry more worse prognosis than those
treated III strokes units so we concluded that the site of treatment is one
of the prognostic factors in hemorrhagic strokess.
Regarding to associated diabetes or cardiac comorbiditys: This study
found that presence of diabetes or cardiac diseases carry more worse A.
prognosis) so we conclude ,that tl1e diabetes and cardiac diseases are
factors which affect the prognoses of hemorrhagic strokes.
Regarding to the incontinence: This study found that incontinence of
urine is one of the prognostic factors in hemorrhagic strokes.
Regarding to the higher cerebral dysfunction: This study found that
large number of cases who had higher cerebral dysfunction had worse
prognosis so it is considered as one of predictor for prognosis.
Regarding to the degree of muscle flaccidity and paralysis: Our results
found that the degree of muscle flaccidity on paralyzed side correlate ------------------------t -lSl-jDF--------- =
SUMMARY
positively with the short term outcome and long term outcome, and there
is linear correlation between degree of paralysis and prognosis in a sense
that increase the degree of paralysis is usually associated with worse
prognosis. So, we considered muscle flaccidity and paralysis are factors
affecting the prognosis of hemorrhagic strokes.
Regarding to the speech disorders: Patient with aphasia had worse
prognosis than dysarthria and patient with no speech disorder. So, we
concluded that global aphasia is one of the predictor of outcome in
hemorrhagic strokes.
Regarding to the S.B.P. and D.B.P.· This study found that higher blood
pressure at admission is one of the prognostic factors in hemorrhagic
strokes.