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Predicting Deterioration in Patients with Lobar Haemorrhages
JNNP 66:600-605, Flemming,K.D.,et al, 1999
See this aricle in Pubmed

Article Abstract
Initial CT characteristics predictive of deterioration included haemorrhage volume >60 ml (63% v 16%, p< 0.0001), effacement of the contralateral ambient cistern (33% v 0%, p<0.0001), and widening of the contralateral temporal horn (50% v 0 %, p<0.0001). Patients presenting and deteriorating within 12 hours of ictus declined due to enlargement of the haemorrhage. Those who deteriorated more than 12 hours after initial neurological symptoms, showed increased mass effect secondary to oedema. Patients with lobar haemorrhages presenting immediately after ictus are at risk for deterioration from enlargement of the haemorrhage and predictors of deterioration may be absent. Patients with large volume lobar haemorrhages presenting to the emergen cy department with decreased level of consciousness and shift on CT are at risk for further deterioration and worsening oedem. These patients require close observation and early aggressive management may be warranted.
 
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