Clinical, Radiologic evaluation Clinical status was evaluated with gender, age, and Glasgow coma scale (GCS). Clinical outcome was evaluated with the GOS6). Patients with a GOS of 4-5 were considered to be a fa- vorable outcome group. On contrary, patients with a GOS of 1-3 were considered to be an unfavorable outcome group. Ac- cording to hematoma location, radiologic findings were classi- fied into temporal, sylvian fissure, and frontal groups (Fig. 1). Hematoma volume was measured with abc/2 methods. We also evaluated lesion lateralization, degree of midline shift, and an- eurysm size. Surgical methods and postoperative management All patients were operared with a routine pterional approach. If severe brain swelling was found, duroplasty and decompres- sive craniectomy were performed. The medial transsylvian ap- proach and lateral transsylvian approach were chosen appropri- ately in each situation with a goal for less brain retraction and less brain injury. All surgery was performed on the day of ad- mission. Postoperative CT brain contrast perfusion images were obtained for all patients to evaluate perfusion values such as ce- rebral blood flow, cerebral blood volume, and mean transit time. According to each perfusion value, we performed osomothera- py with mannitol, or treated with a calcium channel blocker such as Nimodipine®. In case of vasospasm events, 3H therapy of hypertension, hypervolemia, hemodilution was performed. Statistical analysis All parameters were evaluated retrospectively. Prognostic fac- tors were evaluated with a chi-square test, independent t-test, receiver opera- tion characteristic (ROC) curve, McNe- ICH Location mar test, and nonparametric chi-square test with significance defined as less Frontal than 0.05. All statistical analysis was performed with commercial software Sylvian fissure (Predictable Analysis Soft Ware, Ver- sion 18.0, IBM Inc.) Temporal RESULTS Age Patients’ mean age was 58.2 years. Pa- tients aged 65 years and younger had a significantly better prognosis than those over 65 years (p<0.05). Classifying the patient groups based on hematoma lo- cation showed that younger patients with ICH on the frontal lobe or sylvian fissure had a significantly better prognosis. Meanwhile, patients with ICH on the temporal lobe did not show any correla- tion between age and prognosis (Table The Prognostic Factors in Ruptured MCA with ICH | JW Oh, et al. 2). By classifying the patients based on hematoma amount, its volume less than 31 mL had some correlation where younger age meant better prognosis. However, if the amount of hemato- Table 1. Demographic statistics of ruptured MCA, aneurysm with ICH Prognostic factors Age Range 36-74 (yrs) Mean 58.2 (yrs) Gender Male 11 (26.8%) Female 30 (73.2%) Aneurysmal size Small 11 (26.8%) Large 29 (70.7%) Giant 1 (2.4%) Lateralization Dominant 23 (56.0%) Non-dominant 18 (43.9%) GCS score Mild 19 (46.3%) Moderate 17 (41.5%) Severe 5 (12.1%) Location Frontal 18 (43.9%) Sylvian fissure 11 (26.8%) Temporal 12 (29.3%) MCA : middle cerebral artery, ICH : intracerebral hemorrhage, GCS : Glasgow coma scale Table 2. Age and clinical outcome according to location Age (yrs) Outcome ≤65 Unfavorable 0 Favorable 13 Unfavorable 0 Favorable 8 Unfavorable 3 Favorable 6 Total Unfavorable 3 Favorable 27 ICH : intracerebral hemorrhage >65 1 1 3 3 2 1 6 5 Total 1 14 3 11 5 7 9 32 p-value p<0.05 p<0.05 p>0.05 p<0.05 A B C Fig. 1.Type of intracerebral hemorrhage. Axial CT scans, preoperation. A : Temporal type. B : Frontal type. C : Sylvian fissure type. 81