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[Thalamic hypertensive hemorrhage].

N V Vereshchagin, V V Peresedov, A V Shirshov

    Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
    |January 1, 1997
    PubMed
    Summary

    External ventricle drainage (EVD) significantly reduces mortality in thalamic hypertensive hemorrhage (THH) patients. This surgical intervention lowers intracranial pressure, improving outcomes compared to conservative treatment for severe cases.

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    Area of Science:

    • Neurosurgery
    • Neurology
    • Critical Care Medicine

    Background:

    • Thalamic hypertensive hemorrhage (THH) is a severe stroke subtype with high mortality.
    • Treatment decisions and prognosis are influenced by clinical and tomographic factors.
    • Intracranial pressure monitoring is crucial for managing THH.

    Purpose of the Study:

    • To analyze the outcomes of conservative versus surgical (external ventricle drain - EVD) treatment for THH.
    • To identify clinical and tomographic factors influencing treatment choice and prognosis in THH patients.
    • To evaluate the impact of EVD on intracranial pressure and neurological status.

    Main Methods:

    • Statistical analysis of 23 THH patients treated conservatively or with EVD within 48 hours of stroke onset.

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  • Investigation of clinical factors including Glasgow Scale score, hydrocephalus, brainstem dislocation, and intraventricular hemorrhage.
  • Monitoring of intracranial pressure and assessment of hemorrhage volume and location.

    • Main Results:

    • Mortality was approximately twice lower in the EVD group (6/23) compared to the conservative group (17/23).
    • Unfavorable prognostic factors for conservative treatment included low Glasgow score, obstructive hydrocephalus, brainstem dislocation, intraventricular hemorrhage, and hemorrhage volume.
    • EVD indicated for unfavorable THH signs, leading to controlled intracranial pressure decrease, improved consciousness, and reduced hydrocephalus and brainstem dislocation.

    Conclusions:

    • EVD is a more effective treatment for severe THH, associated with significantly lower mortality rates.
    • Early identification of prognostic factors guides timely EVD intervention for unfavorable THH cases.
    • Controlled intracranial pressure management via EVD improves neurological outcomes in THH patients.