J Korean Neurosurg Soc.  2005 Apr;37(4):300-302.

Surgical Resuscitation of a Patient with Cerebral Herniation Secondary to Massive Hemorrhage in the Basal Ganglia: Ultrasound-monitored Aspiration

• Jung YH
• Park JC
• Hamm IS

Abstract

The authors report a case of hyperacute, massive hemorrhage in the left basal ganglia with severe midline shift that was treated successfully by the ultrasound-monitored free hand aspiration technique. Every effort was made to shorten time until removal of considerable amount of the hematoma and minimize duration of cerebral herniation, avoiding additional irreVersible neurological deficit. A burr hole aspiration technique was preferred to standard craniotomy procedure, and any time-consuming procedures such as stereotactic frame application were abandoned. A burr hole was localized on the basis of computed tomography images simply and quickly with a ruler, and safety of the aspiration procedure was augmented by real-time ultrasound monitoring. Such minimally invasive technique relieved cerebral herniation successfully while avoiding time consumption and the morbidity of major craniotomy procedure. Early resuscitation of the patient with cerebral herniation in this case resulted in excellent recovery of the patient's neurological deficit. The patient's mentality started to improve rapidly and was clear six months after the surgery.

Keyword

Aspiration; Cerebral herniation; Free hand technique; Intracerebral hemorrhage; Ultrasound-monitored

MeSH Terms

Basal Ganglia*
Cerebral Hemorrhage
Craniotomy
Hand
Hematoma
Hemorrhage*
Humans
Resuscitation*
Ultrasonography