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Spontaneous intracerebral haemorrhages are the most dangerous complication of cerebral vascular disease. Because of their frequency and the fact that they lead to serious injuries, prolonged disabilities and, often, death, they have acquired an enormous significance, both medically and socially. Their precise diagnosis, location, wide extent and accomp~ying manifestations were for a very long time uncertain and, in small and deeply situated haematomas, these factors were impossible to determine. Diagnosis was confirmed by the clinical picture, by angiography and sometimes by ventriculography and included, in the main, both lobar and more extensive haematomas. The results of operative treatment following the first attempt of H. Cushing in 1903 were poor and remained unsatisfactory in spite of the endeavours of numerous authors (Guillaume et al. 1956; Lazorthes 1956; McKissock et al. 1959; Luessenhop 1967 and many others). Especially for the most frequent and typically hypertensive haematomas in the region of the internal, capsule, the opinion was often expressed that operative treatment was useless.
List of contents
1 Special Lecture.- Stroke.- 2 Morphology and Aetiology.- 2.1 Pathology and Aetiology of ICH.- 2.2 Haemorrhage and Haematoma - Morbid Anatomy.- 2.3 Diagnosis and Control of Bleeding Disorders.- 2.4 ICH in Clotting Disorders.- 2.5 Micro-angiomas and ICH.- 2.6 ICH in Childhood.- 2.7 Familial Incidence of ICH.- 2.8 ICH in Sinus and Cerebral Vein Thrombosis.- 2.9 Role of Traumain ICH.- 2.10 Haematomas of Unknown Aetiology.- 2.11 Stroke and ICH in Spontaneously Hypertensive Rats.- 3 Epidemiology.- 3.1 Epidemiology of ICH in Europe.- 3.2 Epidemiology of Hypertensive ICH in Japan.- 3.3 ICH and their Aetiology in India.- 3.4 WHO Statistics of Mortality in ICH.- 4 Clinical Pathology.- 4.1 Cerebral Blood Flow in ICH (Is Outcome Determined by Irreversible Haemodynamic Factors?).- 4.2 Intracranial Pressure in ICH.- 4.3 Sequential Changes in Tissue Surrounding ICH.- 4.4 Brain Abscess Following ICH.- 5 Aetiological Aspects of Location.- 5.1 Pathology and Aetiology of Supratentorial Haemorrhage.- 5.2 Haematomas in Hemispheric Lobes.- 5.3 Intraventricular Haematoma and Haemorrhage.- 5.4 Correlation Between Ventricular Haemorrhage and Chronic Cerebral Ischaemia in Adult Moya-Moya.- 5.5 Cerebellar Haematomas.- 5.6 Spontaneous Brain Stem (Pontine) Haematomas.- 6 Diagnosis.- 6.1 Angiography in ICH.- 6.2 Computerized Tomography (CT) in ICH.- 6.2.6 Natural History and Follow-Up.- 7 Conservative Treatment.- 7.1 The Immediate Care of Stroke.- 7.2 Conservative Therapy of Spontaneous ICH.- 7.3 Rehabilitation after Acute ICH.- 7.4 Initial Clinical Course and Prognostic Factors in ICH.- 7.5 Late Prognosis.- 8 Operative Treatment.- 8.1 General Surveys.- 8.1.1 Experiences with Operation in 149 Cases of Spontaneous ICH (1966-1977).- 8.2 Grading and Timing.- 8.3 Aetiology - Indications andPrognosis.- 8.4 Location - Indications and Prognosis.- 8.5 Special Technical Problems.- 9 Conclusions.- 9.1 Conservative and Surgical Management.- 9.2 Prospects. The Editors.- 10 References.- 11 Subject Index.
