THE RADIOLOGICAL (CT) AND CLINICAL SEQUELAE OF PRIMARY INTRACEREBRAL HEMORRHAGE

To determine the radiological and clinical outcome of primary intracerebral haemorrhage, a prospective study was carried out involving computed tomography (CT) of 388 consecutive Chinese patients admitted with acute stroke to a large public hospital in Hong Kong. Further CT and functional assessment were performed 3 months later in 71% of survivors. The patients were admitted over a 6 month period. 120 (31%) were found to have had presumed primary intracerebral haemorrhage. Of these, 64 patients (53%) died within 3 months. From 40 of the 56 survivors who returned for a follow-up study at 3 months, 30 were functionally independent and five mildly disabled; only five were significantly disabled. Follow-up CT showed no residual lesion in 27%, low attenuation areas in 37%, slit-like lesions in 25% and calcification in 10% of patients. The size of residual lesions correlated statistically with the degree of residual disability, although the association was not close. It is concluded that primary intracerebral haemorrhage accounts for a high percentage of strokes among Hong Kong Chinese with more than half of the patients dying within 3 months. Many survivors, in whom follow-up CT appearances are variable, show good functional recovery.