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Chapter 45 - Lobar hemorrhages

from Section 2 - Vascular topographic syndromes

Published online by Cambridge University Press:  05 August 2012

By
Carlos S. Kase
Edited by
Louis R. Caplan  and
Jan van Gijn
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Jan van Gijn
Affiliation:
University Medical Center, Utrecht
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Summary

Lobar intracerebral hemorrhages (ICHs) involve the white matter of the cerebral lobes, and originate at the corticosubcortical gray matter-white matter junctions. Lobar hemorrhages are distinct from other forms of ICH in their clinical presentation, causes, prognosis, and management. Lobar hemorrhage has been thought to have a better prognosis than the deep hemispheric (putaminal, thalamic) and posterior fossa hemorrhages. The case fatality rates reported have ranged between 11% and 32%, in comparison with 42% for basal ganglionic and thalamic ICH, and 43% for posterior fossa hemorrhages. The observed differences in case fatality between lobar and deep ICH probably reflect variations in hematoma size and mass effect more than their superficial versus deep location. The value of medical and surgical therapy for lobar ICH will ultimately have to be determined by clinical trials involving randomization of comparable groups of patients to one or the other type of treatment.

Keywords

recurrent strokesmultiple brain infarctsmultiple cerebral infarctsvenous infarctsbihemispheric multiple infarctscardioembolismacute multiple infarctsmultilevel infarcts
Type
Chapter
Information
Stroke Syndromes, 3ed , pp. 516 - 525
Publisher: Cambridge University Press
Print publication year: 2012

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