Evaluation of cerebral edema after intracerebral hemorrhage and analysis of the risk factors for the severity of cerebral edema

Objective Evaluate cerebral edema after intracerebral hemorrhage(ICH)by a modified method and analyze the risk factors for the severity of cerebral edema.Methods Patients with ICH(volume more than 10 ml)were reviewed.CT scans in all the patients were performed on day 0,day 3,day 7 and day 14 after onset of ICH,volume of hematoma and cerebral edema were evaluated with ABC method or modified method.Using univariate analyses,the risk factors for the severity of cerebral edema were revealed.Results 140 cases were included in the present study,mean volume of hematoma was 23.87±8.2 ml on day 0 after ICH.Compared with day 0,volume of hematoma decreased significantly on day 14(P0.01).Cerebral edema was observed on day 0,volumes of cerebral edema on day 3,day 7 and day 14 were obviously higher than that on day 0(P0.01).Volume of hematoma measured by the modified method was similar to that measured by the traditional method,while volume of cerebral edema evaluated by the modified method was significantly higher than that measured by the traditional method on day 0,day 3 and day 14(P0.05).Volume of cerebral edema was significantly higher in the patients with great hematoma,diabetes mellitus,ischemic cerebral vascular disease,pulmonary infection,renal inadequacy,hyponatremia or mass effect(P0.05,P0.01).Conclusion Severity of cerebral edema changes along with the period after CH.Compared with the traditional method,the modified method is more accurate for the measurement of the cerebral edema.Great hematoma,diabetes mellitus,ischemic cerebral vascular disease,pulmonary infection,renal inadequacy,hyponatremia and mass effect are the risk factors for the severity of cerebral edema.