A clinical study of cerebral hemorrhage in non-diabetic normotensives vs non?diabetic hypertensives and the role of nimodipin

Background: Intra cerebral hemorrhage accounts for 10-15% of all cases of stroke and is associated with highest mortality rate, with only 38% of affected patients surviving the first year. Materials and methods: All cases of cerebro vascular accident (CVA) presented to Gandhi Hospital, Musheerabad, were considered, and the cases of CVA with intra cerebral hemorrhage evidenced by lumbar puncture and CT scan brain were prospectively studied at Department of Medicine, Gandhi Hospital Muheerabad, between May 2002 and April 2004. Results: Out of 63 cases, 22 cases were with non-diabetic normotensive, and non-risk factors; and 41 cases were with non-diabetic hypertension; two groups of cases were studied separately and the comparison was made. Total number of 254 Cerebro Vascular Accident (CVA) cases was presented to Gandhi Hospital, Musheerabad. Cerebral thrombosis were 171, Cerebral embolism were 20, and intra cerebral hemorrhage were 63. Out of 63 intra cerebral hemorrhage cases, 41 were hypertensive and 22 were normotensive. Out of 41 hypertensive patients, 23 died and 18 survived; out of 22 normotensive patients, 3 died and 19 survived. All cases were given broad spectrum antibiotic (inj. Ampicillin 500 mg IV 6th hourly, Inj. Flagyl 500 mg IV 8th hourly and Inj. Gentamycin 80 mg IV 12th hourly), Inj. Mannitol 100 mg IV 8th hourly, tablet Nimodipin 30 mg 8th hourly, proper care was taken and appropriate physiotherapy was given. Conclusion: It is useful to identify the risk factors for intra cerebral hemorrhage in normotensives, because the cause was identified in 5 cases, 4 cases with aneurysm, one case with arterio venous malformations (AVM’s) and most of the cases who belong to 5th and 6th decade, the cause for intra cerebral hemorrhage was not known. Nimodipin was used in all the cases as initial medical treatment, with good results, when compared to 50% mortality in other studies where Nimodipin was not given.