{"id":211,"date":"2002-10-12T14:08:27","date_gmt":"2002-10-12T19:08:27","guid":{"rendered":"http:\/\/blogs.law.harvard.edu\/neurovista\/2002\/10\/12\/from-the-literature\/"},"modified":"2002-10-12T14:08:27","modified_gmt":"2002-10-12T19:08:27","slug":"from-the-literature","status":"publish","type":"post","link":"https:\/\/archive.blogs.harvard.edu\/neurovista\/2002\/10\/12\/from-the-literature\/","title":{"rendered":"From the literature&#8230;."},"content":{"rendered":"<p><a href=\"http:\/\/www.thejns-net.org\">Journal of Neurosurgery<\/a>&nbsp;2002 Sep;97(3):531- <\/p>\n<p><strong>Prediction of death in patients with primary intracerebral hemorrhage: a prospective study of a defined population.<\/strong> <\/p>\n<p>Nilsson OG, Lindgren A, Brandt L, Saveland H. from the Lund University Department of Neurosurgery.<\/p>\n<p>Summary:&nbsp; The authors prospectively assessed those factors associated with 30 day and 1 year mortality in a population of patients with primary intracerebral hemorrhage.&nbsp; In the 341 cases studied, the mortality rate was 36% at 30 days and 47% at one year.&nbsp;&nbsp; Initial level of consciousness, hematoma volume, and heart disease were independent co-factors for early mortality.&nbsp;&nbsp; Age was also a factor that predicted&nbsp;one year mortality. 72% of those with hematoma volume greater than 60 cc were deceased at 30 days whereas 19% of those with volume of less than 30 cc were deceased at 30 days. At the one year time point both deep and lobar hemorrhages had over 40% mortality.&nbsp; &nbsp;<\/p>\n<p><font color=\"darkblue\">Commetary:&nbsp; This report benefits from a prospective design,&nbsp;multivariate statistical analysis.&nbsp;&nbsp;The emphasis on volume of hemorrhage and the level of consciousness are well warranted.&nbsp; Greater than 80% of those who presented in coma were dead at 30 days.&nbsp; What are the implications for the practicing neurosurgeon?&nbsp;&nbsp;The question of when to evacuate intracerebral hematoma remains with us and these decisions must be made rapidly.&nbsp; One advance would be software that would allow for segmentation and volume calculations proximate in time to the original CT scan.&nbsp; To be called from the emergency room regarding a&nbsp;57 cc hemorrhage in the occipital pole versus a 23 cc cerebellar hemorrhage would instantly convey important information about overall prognosis.&nbsp;&nbsp;This would permit the development of clinical protocols that could be rapidly implemented for trials of minimally invasive evacuation or other therapies.&nbsp; &nbsp;In conjuction with location data, this would allow us to go beyond the gestalt of &#8220;large&#8221; or &#8220;small&#8221; hemorrhages and be more quantitative.&nbsp; ~Bob Carter, M.D.<\/font><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Journal of Neurosurgery&nbsp;2002 Sep;97(3):531- Prediction of death in patients with primary intracerebral hemorrhage: a prospective study of a defined population. Nilsson OG, Lindgren A, Brandt L, Saveland H. from the Lund University Department of Neurosurgery. Summary:&nbsp; The authors prospectively assessed those factors associated with 30 day and 1 year mortality in a population of patients [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-211","post","type-post","status-publish","format-standard","hentry"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/posts\/211","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/comments?post=211"}],"version-history":[{"count":0,"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/posts\/211\/revisions"}],"wp:attachment":[{"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/media?parent=211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/categories?post=211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/neurovista\/wp-json\/wp\/v2\/tags?post=211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}