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[Cerebrovascular disease in the elderly--clinical study of 31 cases with acute intracerebral hemorrhages].

Thirty-one consecutive cases of intracerebral hemorrhage (ICH) in the elderly (over 70 years at the onset) were reported with special reference to neurological evaluations, prognosis and mortality in the acute phase. There were 11 men and 20 women with ICH, who were admitted to the Yokufukai Geriatric Hospital within 24 hours after the onset of ICH. Their ages at the onset ranged from 71 to 93 years with a mean of 81.1 years. The lesion location showed 5 cases with thalamic hemorrhage, 4 cases with putaminal hemorrhage, 6 cases with subcortical hemorrhage, 7 cases with cerebellar hemorrhage, 8 cases with mixed hemorrhage and 1 case with unclassified hemorrhage. 61.3% of all cases showed the onset during daytime but the remaining awoke in the morning with their symptoms or had the onset from the stage of the bedridden state. The classical prodromal symptoms headache and nausea or vomiting were found in 30% and 54.8%, respectively. Two cases with cerebellar hemorrhage were accompanied by vertigo. Twenty-four patients had consciousness disturbance at admission. There were 18 cases with right or left hemiparetic symptoms, 5 cases with tetraparesis, and 5 cases without motor dysfunction. The remaining already had hemiparesis due to old stroke. Patients with mixed hemorrhage usually exhibited conjugate deviation. In 9 of 31 cases there were mental symptoms such as wandering or night delirium. The 30-day mortality rate was 64.5% and sixty-five percent of them died within 6 days after the onset of ICH. Consciousness at admission was the overwhelming predictive factor.(ABSTRACT TRUNCATED AT 250 WORDS)