Abstract
We examined the relation of aging to the localization of hematomas in 644 consecutive patients with spontaneous intracerebral hemorrhage (ICH), who were admitted to Kitasato University Hospital.
The ages of the 644 patients varied from 16 to 92 years, with a mean of 58.9 ± 12.4 years. Although the highest incidence of ICH was found to occur in patients aged 50-59 years of either sex, ICH was more common in men than in women up to the age of 69 years. Among the patients aged >70 years, there was no difference in incidence of ICH between the sexes.
In the patients with ICH, the location of the hematomas was classified on the basis of the CT findings into the putamen (n=233, mean age of 55.6 ± 11.3 years), thalamus (n=167, 61.3 ± 10.9 years), pons (n=69, 53.9 ± 9.4 years), cerebellum (n=61, 67.6 ± 9.9 years), subcortex (n=78, 60.6 ± 16.7 years), or other locations. The mean ages of the patients with putaminal hemorrhage and with pontine hemorrhage were significantly lower than those of the patients with cerebellar hemorrhage and with subcortical hemorrhage. The group aged <40 years more commonly had putaminal hemorrhage (60%). Pontine hemorrhage was also common in the group aged <50 years, while in the group aged >60 years, cerebellar hemorrhage occurred more frequently.
The presence of hypertension was found to be related to the localization of the hematomas. Thus, 213 of 233 patients with putaminal hemorrhage (91%) and 63 of 69 with pontine hemorrhage (91%) revealed hypertension in their history, while 44 of 61 patients with cerebellar hemorrhage (72%) and 46 of 78 with subcortical hemorrhage (59%) had hypertension.
These results suggest that putaminal hemorrhage and pontine hemorrhage occur more commonly in patients of relatively young age, and that persistent hypertension may be more closely related to the pathogenesis of bleeding in these locations.
