Gastrointestinal bleeding in patients with severe head injury, hypertensive intracerebral hemorrhage, and ruptured cerebral aneurysm.

As a complication in patients with head injury or cerebral stroke, gastrointestinal bleeding is an important problem in neurosurgery. We reviewed 411 cases of hypertensive intracerebral hemorrhage, ruptured cerebral aneurysm and severe head injury in order to ascertain the pathologic condition of the gastrointestinal bleeding and to introduce an effective method of therapy. In 411 cases, gastrointestinal bleeding was observed in 19 cases (4. 6%). Among the cases of hypertensive intracerebral hemorrhage or ruptured cerebral aneurysm, the frequency was high in males. Among the cases of severe head injury, the frequency was high in children. Dogmatyl® had no prophylactic effect for gastrointestinal bleeding. Administration of steroids had no relationship to gastrointestinal bleeding. Of the 19 cases with the gastrointestinal bleeding, laparotomy was performed on 6 cases. Of the 19 cases, 10 cases died. From our review, laparotomy is considered to be the most satisfactory method of therapy. 35