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We reviewed predictive factors of poor outcome in pontine hemorrhage in 38 patients admitted to the neurological-neurosurgical intensive care unit. Twenty-one patients died within days of admission(55%).Nine patients were severely or moderately disabled and dependent on others for daily care (24%).Eight patients made a good recovery(21%).Death was significantly more common in patients with a history of hypertension,coma on admission, absent motor response,absent corneal reflex or oculocephalic response. However,clinical and CT features observed only in patient who died were hyperthermia(core temperature>39 degrees C),tachycardia(>110 beat/min),CT evidence of extension into the midbrain and thalamus,and acute hydrocephalus on admission.Good recovery only occurred in patients who were alert on admission and had small unilateral pontine hemorrhages.These clinical profiles should be useful in determining the level of care and future resuscitative efforts. |
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