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Hypertensive basal ganglia hemorrhage: a prospective study comparing surgical and nonsurgical management
1Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
Background:
The optimal treatment of hypertensive supratentorial intracerebral hemorrhage is still debated. Some studies have shown no improvement in survival or functional outcome after surgery when compared to conservative management while others have shown otherwise.
Methods:
This study was a prospective trial, matching patients for hematoma volume and Glasgow Coma score on admission.
Results:
There were a total of 34 patients. Seventeen were treated conservatively and 17 surgically. There was no significant difference between the two groups in terms of age, GCS, hematoma volume, or presence of intraventricular blood. At 3, 6, and 12-month follow-up, they were assessed using the Modified Barthel Index by a blinded observer. There was no difference between the two groups at 3, 6, or 12 months follow-up. The mortality rate was similar in the two groups.
Conclusions:
Based on this study and review of the literature, we cannot recommend routine evacuation of clots to treat these hemorrhages.