A clinical verification of the acute cerebrovascular disease

Part II. A perifocal low density area in the per- and post-operative hypertensive basal ganglionic hematoma

Abstract

A perifocal low density area in C.T. plays an important role to determine the prognosis of the lesion, although its genesis is still controversial.
In this report, the perifocal low density area of the hypertensive basal ganglionic hematoma was evaluated, concerning to its time course in pre- and post-operation, and to the correlation with its histological findings.
The conclusions were obtained as follows :
1) The perifocal low density area can appear within three hours after the attack, particularly in a fulminant case. The low density area is usually occupied by the fluid with blood and CSF which has been certified in the operation at a super-acute stage after the attack.
2) The low density area consisted of brain edema, brain swelling and brain destruction which were certified by the histological study, apperars around six hours after the attack.
3) The low density area with a mass effect is usually observed for two weeks after the removal operation. This duration seems to be longer than our pervious (pre C.T. era) understanding about the duration of the existence of the brain edema, particularly in cases of the incomplete removal of the hematoma, the low density area with the mass effect is observed for more than two weeks after the operation. This fact suggests to give the anti-hyper ICP drugs in longer days than the duration of our previous understanding.