The Clinical Analysis of Stereotactic Aspiration of Spontaneous Intracerebral Hemorrhage

Lee, Jong Chul; Min, Byung Kuk; Park, Kwan; Suk, Jong Sik

Abstract

To date no consensus has been reached regarding the suitability of surgical treatment for spontaneous intracerebral hemorrhage, especially in deep seated cases. With the recent introduction of an alternative to conservative therapy, craniotomy or stereotactic aspiration, it has become even more difficult to determine which therapeutic approaches should be used. We used stereotactic aspiration technique under a local anesthesia instead of craniotomy to treat 48 patients, because we believe that better therapeutic results could be obtained by minimal invasion to the brain. In present study, we analysed the level of consciousness and clinical outcome, location and volume of hematoma, interval of operation from ictus, and rate of hematoma removal. Our series consist of 18 males and 30 females. The most prevalent age group of intracerebral hemorrhage patients were the 6th decades. The hematoma were located at basal ganglia in 75%, thalamus in 15%, pons in 8%, and lobar 2%. The prognosis was favorable in patients with good neurological grade at admission, but was unfavorable in those with large volume although the statistical difference was not significant. Rate of hematoma removal was high in the cases where operations performed after 4 days. The statistical difference between the time interval from hemorrhage to operation and prognosis was not significant. The overall mortality rate was 17%. These results seem to indicate that stereotactic aspiration may play a comparable indices in the treatment of spontaneous intracerebral hemorrhage.