The Fate of Hypertensive Patients with Clinically Proven Spontaneous Intracerebral Hematomas Treated Without Intracranial Surgery

Twenty-five hypertensive patients who had clinically proven intracerebral hematomas, mainly in the internal capsule, were not treated surgically because of stabilization or improvement of their condition or because of extreme brain damage. All of these patients were treated medically, although therapy was not standardized. Ten of the 25 patients were discharged from the hospital and 15 died during their acute illness. Long-term follow-up was ultimately accomplished and the results are recorded. Profound disturbance in sensorium and abnormal pupillary or corneal reflexes were present in those who died, whereas in the group that survived only two patients had coma or stupor and none had bilateral involvement of pupillary or corneal reflexes. Analysis of a group of patients receiving surgery for intracerebral hemorrhage revealed that the mortality was 65%; thus, the results of conservative or surgical therapy were essentially the same.