J Korean Neurosurg Soc.  1988 Jun;17(3):437-446.

Stereotactic Management of Spontaneous Infratenorial Hemorrhage: Part I:Stereotactic Evacuation and Gradual Urokinase Irigation for Spontaneous Brain Stem Hemorrhage

• Cho SH
• Baek SC
• Ihm JH
• Kim OL
• Chi YC
• Choi BY

Abstract

In spontaneous brain stem hemorrhage, efforts are being made to treat the hemorrhage by means of active medical treatment of intricate suboccipital craniectomy. But these efforts are still unsatisfactory in decreasing the high mortality and morbidity. Our recent efforts have got good results in the 11 cases of brain stem hemorrhage by removing the hemorrhage through the application of R.R.W. stereotactic system and gradual urokinase irrigation. The residual hemorrhage following the initial aspiration was completely evacuated by gradual urokinase irrigation through stereotactically placed catheter. Also this catheter was used for monitoring of intrahematomal intracranial pressure for an early stoppage of the increased intracranial pressure or early detecting of rebleeding. This kind of stereotactic evacuation and gradual irrigation with urokinase could remove the brain stem hemorrhage accurately and easily in a short time under the local anesthesia. Mean-while the normal brain tissue is subjected to less surgical trauma by this procedure, which can be interpreted as having a wide indication, a definite advantage, with a low mortality of 27.3%.

Keyword

Brain stem hemorrhage; Stereotatic evacuation; Urokinase irrigation; Intrahematomal pressure monitoring; Impedance

MeSH Terms

Anesthesia, Local
Brain Stem*
Brain*
Catheters
Electric Impedance
Hemorrhage*
Intracranial Pressure
Mortality
Urokinase-Type Plasminogen Activator*
Urokinase-Type Plasminogen Activator