Comparative Clinical Analysis of Surgically Treated Spontaneous Intracranial Parenchymal Hematoma between with Stereotaxic Evacuation and Free-Hand Craniectomy

Baek, Seung Chan; Kim, Wan Shup; Ko, Sam Kyu; Chi, Yong Chul; Choi, Byung Yearn; Moon, Choong Bae; Cho, Soo Ho

Abstract

From Jun, 1983 to Sep, 1986, we operated 127 cases of spontaneous intracranical parenchymal hematoma. Among them, 88 cases were operated by stereotaxic evacuation of hematoma with computed B.R.W. system and 39 cases by free-hand craniectomy and leucotomy. We compared results of both methods. Results are as followings : 1) Nearly 90%(112 cases) were over 40 years old. 2) Prevalence of both sex were nearly same. 3) Hypertension cases on admission were 93 cases(73.2%). 4) Favorite anatomical locations were putamen(55 cases ; 43.3%), thalamus(32 cases ; 25.2%), subcortical(29 cases ; 22.8%), pontine, cerebellum in frequency. 5) Amount of removed hematoma were mostly 10-30ml and upper most case was 145ml. 6) Irrigation with urokinase were done in cases. 7) Surgical complication were 7 cases(5.5%) : 6 cases of reblecding : 1 case of ventriculitis. 8) Mortality of total cases were 26.0%(33 cases). 9) Comparative results between B.R.W. group and F.H.C. group were as followings ;(tab)B.R.W. group(tab)(tab)F.H.C. group(tab)(newline)Mortality(tab)13.60%(tab)(tab)28.20%(tab)(newline)(tab)AD(tab)DC(tab)AD(tab)DC(newline)Glasgow coma scale(tab)11.23+/-3.14(tab)12.72+/-3.87(tab)8.56+/-3.33(tab)10.97+/-4.93(newline)Motor power(tab)2.59+/-1.14(tab)3.44+/-1.27(tab)3.05+/-1.21(tab)3.32+/-1.53(newline)Motor of Putaminal Hx(tab)2.38+/-0.85(tab)3.13+/-1.00(tab)3.20+/-0.94(tab)3.00+/-1.41(newline)