J Korean Neurosurg Soc.  2008 Oct;44(4):185-189. 10.3340/jkns.2008.44.4.185.

Stereotactic Multiplanar Reformatted Computed Tomography-Guided Catheter Placement and Thrombolysis of Spontaneous Intracerebral Hematomas

• Hwang JH
• Han JW
• Park KB
• Lee CH
• Park IS
• Jung JM

• KMID: 2189566
• DOI: http://doi.org/10.3340/jkns.2008.44.4.185

Abstract

OBJECTIVE
The authors present their experiences with stereotactic multiplanar reformatted (MPR) computed tomography (CT)-guided catheter placement for thrombolysis of spontaneous intracerebral hematoma (sICH) and their clinical results.
METHODS
In 23 patients with sICH, MPR CT-guided catheter placement was used to select the trajectory and target point of hematoma drainage. This group was comprised of 11 men and 12 women, and the mean age was 57.5 years (range, 31-79 years). The patients' initial Glasgow Coma Scale scores ranged from 7 to 15 with a median of 11. The volume of the hematoma ranged from 24 mL to 86 mL (mean 44.5 mL). A trajectory along the main axis of the hematoma was considered to be optimal for thrombolytic therapy. The trajectory was calculated from the point of entry through the target point of the hematoma using reformatted images.
RESULTS
The hematoma catheter was left in place for a median duration of 48.9 hours (range 34 to 62 hours). In an average of two days, the average residual hematoma volume was 6.2 mL (range 1.4 mL to 10.2 mL) and was reduced by an average of 84.7% (range 71.6% to 96.3%). The residual hematoma at postoperative seven days was less than 5 mL in all patients. There was no treatment-related death during hospitalization.
CONCLUSION
The present study indicates that stereotactic MPR CT-guided catheter placement for thrombolysis is an accurate and safe procedure. We suggest that this procedure for stereotactic removal of sICH should be considered for the optimization of the trajectory selection in the future.

Keyword

Intracerebral hematoma; Stereotactic aspiration; Surgical treatment; Thrombolysis

MeSH Terms

Axis, Cervical Vertebra
Catheters
Drainage
Female
Glasgow Coma Scale
Hematoma
Hospitalization
Humans
Hypogonadism
Male
Mitochondrial Diseases
Ophthalmoplegia
Thrombolytic Therapy
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia