J Cerebrovasc Endovasc Neurosurg.  2012 Sep;14(3):170-174. 10.7461/jcen.2012.14.3.170.

Stereotactic Burr Hole Aspiration Surgery for Spontaneous Hypertensive Cerebellar Hemorrhage

• Lee JH
• Kim DW
• Kang SD

• KMID: 1808451
• DOI: http://doi.org/10.7461/jcen.2012.14.3.170

Abstract

OBJECTIVE
Patients with severe spontaneous cerebellar hemorrhage typically undergo treatment with suboccipital craniectomy and hematoma evacuation. However, this is a stressful procedure for patients due to the long operating time and operation-induced tissue damage. In addition, the durotomy can result in pseudomeningocele. We investigated the efficacy of stereotactic or navigation-guided burr hole aspiration surgery as a treatment for spontaneous hypertensive cerebellar hemorrhage (SHCH).
METHODS
Between January 2002 and December 2011, 26 patients with SHCH underwent surgery using the stereotactic or navigation-guided burr hole aspiration and catheter insertion technique in our institution.
RESULTS
Mean hematoma volume was 21.8 +/- 5.8 cc at admission and 13.1 +/- 5.4 cc immediately following surgery. Preoperative Glasgow Coma Scale (GCS) score was 12.5 +/- 1.3 and postoperative GCS score was 13.1 +/- 1.2. Seven days after surgery, the mean hematoma volume was 4.3 +/- 5.6 cc, and there was no occurrence of surgery-related complications during the six-month follow-up period. The mean operation time for catheter insertion was 43.1 +/- 8.9 min, and a mean 31.3 +/- 6.0 min was also added for extra-ventricular drainage. The mean Glasgow Outcome Scale (GOS) score after six months was 4.6 +/- 1.0.
CONCLUSION
Stereotactic burr hole aspiration surgery for treatment of SHCH is less time-consuming and invasive than other interventions, and resulted in no surgery-related complications. Therefore, we suggest that this surgical method could be a safe and effective treatment option for selected patients with SHCH.

Keyword

Cerebellar hemorrhage; Aspiration; Stereotactic; Navigation; Outcome

MeSH Terms

Catheters
Drainage
Follow-Up Studies
Glasgow Coma Scale
Glasgow Outcome Scale
Hematoma
Hemorrhage
Humans

Figure

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  Fig. 1 A 56-year-old male patient presented with a drowsy mental status. (A) Findings on brain Computed tomography (CT) at admission shows spontaneous cerebellar hemorrhage with mild brain stem compression and obstruction of the fourth ventricle. The hematoma volume was 26 cc and maximal hematoma diameter was 49 mm. (B) Brain CT at three days after surgery shows residual hematoma with catheter after stereotactic aspiration surgery.

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