Tissue elastance and fluid conduction in normotensive and hypertensive intracerebral mass haematomas.

This is an investigation into the prognostic factors of 117 patients with spontaneous normo- and hypertensive intracerebral haematomas, supported by animal experiments. Preserved tissue elastance and fluid conduction enables the drainage of intrinsic haematoma serum into the CSF spaces in normotensive patients, who showed an increased extension of a perifocal hypodensity in the CT. Arterial hypertension decreased the possibility of fluid resolution. Our experimental studies showed that in hypertensive cases the serum remained trapped in the haematoma, which explains the small hypodense area around the haematoma in most of the hypertensive cases. If as an exception in hypertensives of perifocal hypodensity develops then it acts as additional space-occupying factor. Corresponding observations were made in hypertensive animals which showed a reduced serum movement out of the haematoma, but an increased Evans-Blue content in the perifocal tissue. Both pathological mechanisms explain the poorer prognosis in patients with intracerebral haematomas associated with high arterial blood pressure.