1Chonnam National University Hospital, Gwangju, Republic of Korea
Method: In surgically treated 312 patients with ICH between January 2010 and December 2015, 44 patients were included in this study. We measured contralateral hemispheric brain area in three different level of axial brain computed tomography (CT) images using CT based software. Proportion of contralateral hemispheric parenchyma to intracranial area was measured to adjust individual difference in head size. We analyzed relationship between various possible factors and the contralateral hemispheric volume change.
Results: The median follow up interval between preoperative and postoperative brain CT was 89.5 days (range, 30–180). The average volume ratios of preoperative and postoperative contralateral hemispheric parenchyma were 92.3% vs. 88.8%, 90.3% vs. 85.3% and 86.9% vs. 82.5% in the level of third ventricle, septum pellucidum and lateral ventricle, respectively. The declination of contralateral parenchymal volume ratio had all statistical significance in three different levels through paired t-test (p-value <0.001). In various possible factors, presence of intraventricular hematoma (IVH) was the most significant factor for contralateral parenchymal volume ratio decrease (p-value = 0.006). Glasgow coma scale (GCS) on arrival and smoking were independent factors in multivariate analysis (p-value = 0.016, 0.039).
Conclusion: Contralateral parenchymal volume ratio was decreased significantly on the 3 months follow up brain CT scan. The mechanism of this morphological change might be associated with neuroinflammation and diaschisis.