Influence of liver dysfunction on volume of putaminal hemorrhage.

Abstract

We studied the relations of age, sex, hypertension, alcohol consumption, liver dysfunction, and thrombocyte count to the volume of the hematoma in 141 patients with spontaneous putaminal hemorrhage. Hematomas were significantly larger in men, regular alcohol consumers, those with liver dysfunction, and those with low platelet counts. Our findings reflect the fact that almost all of the alcohol consumers were men, most of them had liver disorders, and the volume of hematoma in such patients was relatively large. (Stroke 1988; 19:987-990) S everal authors have pointed out the correlation between spontaneous intracerebral hemorrhage and liver dysfunction. 1 -3 We have also reported 4 that among men with cerebral hemorrhage, many had abnormal liver functions due to excessive alcohol use. As a result, the men had significantly lower platelet counts and serum fibrinogen concentrations, factors that may have contributed to a condition in which hemorrhage is likely to occur.These considerations led us to hypothesize that patients with liver disorders, specifically those with deficits in the mechanisms of hemostasis, may have hematomas of unusually large size due to the fact that, once bleeding begins, hemostasis does not easily occur. To test this hypothesis, we studied 141 patients with putaminal hemorrhage who came to our clinic over 3 years. We studied these patients with regard to the relations of age, sex, presence of hypertension, alcohol consumption, liver dysfunction, and thrombocytopenia to the volume of the putaminal hemorrhage. Our predictions were confirmed. Subjects and MethodsBetween January 1984 and December 1986, we examined 189 patients with spontaneous putaminal hemorrhage in whom diagnoses of vascular anomaly, such as cerebral aneurysm, arteriovenous malformation, or moyamoya disease, were excluded on the basis of cerebral angiography. There were 141 patients (98 men and 43 women) admitted ^24From the Division of Neurosurgery, Institute of Brain Diseases, Tohoku University School of Medicine, Sendai, Japan.Address for reprints: Hiroshi Niizuma, MD, Division of Neurosurgery, Institute of Brain Diseases, Tohoku University School of Medicine, Seiryo-cho 1-1, Sendai, Japan 980.Received January 25, 1988; accepted March 24, 1988. hours after the onset of symptoms and on whom computed tomography (CT scans), platelet counts, and examinations of liver functions (glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT], gamma-glutamyl transpeptidase [y-GTP], and y-globulin fractions) were carried out. The men ranged in age from 30 to 84 (mean±SD 53.5 ±11.5) years and the women from 41 to 77 (mean±SD 59.2 ±8.0) years. A history of hypertension was found in 73 men (74%) and 35 women (81%). Histories of liver or gall bladder disorders were found in seven men (three had had acute viral hepatitis, two chronic hepatitis, one liver cirrhosis, and one Weil's disease) and two women (with cholelithiasis). There were, in addition, three cases of renal failure (one of whom had severe anemia and a pro...

Intracerebral Hemorrhage in Patients With Chronic Liver Disease

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The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage

“…Bazı çalışmalarda İSK'nın nedeni olarak altta yatan trombosit fonksiyon bozukluğu suçlanmıştır (10)(11)(12). İSK'lı hastalarda trombosit fonksiyonlarını değerlendiren az sayıda çalışma olup bu çalışmaların sonuçları arasında çelişkiler bulunmaktadır (1,6,8).…”

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