원발성 뇌실질 출혈 후 이차적 혈관질환

Abstract

Background and Objectives : Secondary vascular events in the patients with spontaneous primary intracerebral hemorrhage (PICH) have been rarely investigated. The aim of the present study is to analyze the type and incidence of vascular events (VE) after first spontaneous PICH. Patients and Methods : We reviewed the medical records of 269 patients with spontaneous PICH admitted to Kang-nam St. Mary’s Hospital between 1994 and 1998. We followed these patients (mean 23 months) and made a telephone interview regarding the occurrence of VE including stroke, coronary artery disease (CAD), and peripheral vascular disease. R e s u l t s : Secondary VE occurred in 24 patients (8.9 %) of 269; ICH in 13 (4.8 %), cerebral infarct in 10 (3.7 %), and CAD in 1 (0.4 %). Factors such as male gender, the presence of hypertension and previous ischemic vascular diseases tend to be more common in patients with recurrence. Hypertension was relatively common in patients with recurrent ICH while previous ischemic vascular event, alcohol and smoking were relatively common in patients with recurred ischemic VE as compared to those without. Among patients with previous ischemic vascular diseases, none of the patients on anti-platelets developed recurrent VE. Conclusion : Patients with PICH are at risk for both recurrent cerebral hemorrhage and ischemic vascular diseases. Therefore, we suggest that selected patients need to take action against ischemic VE events such as antiplatelet agents after resolution of hematoma. Korean Journal of Stroke 2000;2(2): 171~174