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腦卒中에 關한 硏究

Clinical Studies on Cerebrovascular Accidents

경희한의대논문집 1980년 3권 0호 p.227 ~ 237
박준하,
소속 상세정보
박준하 (  ) - 경희대학교 의과대학 내과학교실

Abstract


Three hundreds and thirty-nine patients of cerebrovascular accidents were studied clinically during three years from October 1971 to September 1974 in the Department of Internal Medicine, Kyung Hee University Hospital.
The diagnostic criteria of cerebrovascular accidents was based on the Okinaka´s modification of Millikan´s classification.
1. Cerebrovascular accidents were found in 12.7% of total admissions of medical department.
2. Among 339 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 54.28%, cerebral thrombosis in 23.59%, subarachnoid hemrrhage in 11.79%, cerebral embolism in 4.13%, transient cereberal ischemia in 4.42%, and hypertensive encephalopathy in 1.79%.
3. The distribution of sex in cerebrovascular acidents disclosed that male was dominant with 59.29% of patient, (the male to the female ratio was 1.46:1). The ratio between male and female was 1.35:1 in cerebral hemorrhage, 1.6:1 in cerebral thrombosis, and 1.5:1 in subarachnoid hemorrhage.
4. The distribution of age in cerebrovascular accidents disclosed that the sixth decade was most predominant, followed by thy the seventh and the fifth decade in turn.
5. The underlying diseases in cerebrovascular accidents were found in the majority of the patients and especially the hypertension was found in 90.22% of those with cerebral hemorrhage in 85.0% of subarachnoid hemorrhage, in 66.25% of cerebral thrombosis, in 64.28% of cerebral embolism, in 60.0% of transient cerebral is chemia, and in 100% of hypertensive encephalopathy.
6. The mortality rate in cerebrovascular accidents was 46.9%; 64.48% in cerebral hemorrhage, 20.0% in cerebral thrombosis, 20.0% in subarachnoid hemorrhage, 57.14% in hypertensive encephalopathy, and no death in transient cerebral ischemia. The duration from the onset of cerebrovascular accidents to death disclosed that 52.38% of the patients died within 24 hours all of which were with cerebral hemorrhage, and 7.15% died after one week.
7. The fundoscopic findings in cerebrovascular accidents by Keith-Wagner classification disclosed that grade II were found in 42.31%, grade III in 25.21%, and grade I in 16.24% in turn. The elctrocardiographic findings were abnormal in 87%; left ventricular hypertrophy was
found most frequently in 78.74% among the abnormal ECG, and atrial fibrillation was found in 92.86% of cerebral embolism.
The findings of cerebrospinal fluid disclosed that bloody CSF was found in 48.44% which was associated with cerebral hemorrhage or subarachnoid hemorrhage. In cerebral hemorrhage, 70.4% was bloody, 19.2% was xanthochromic and only 10.4% was clear, whereas 95.92% was clear in cerebral thrombosis.

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