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Updated: Aug 17, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
[Neurosurgical treatment of spontaneous intracerebral haematomas]
B Durović1, G Tasić, V Jovanović
1Institut za neurohirurgiju, KC Srbije.
Insights
Surgery for spontaneous intracerebral haematomas (ICH) in patients with severe consciousness disturbance shows a high mortality rate. Survival is linked to less severe coma and younger age.
Area of Science:
- Neurosurgery
- Neurology
- Trauma Care
Context:
- Spontaneous intracerebral haematomas (ICH) pose significant management challenges.
- Surgical intervention is considered for patients with severe consciousness disturbance.
- Preoperative assessment relies on CT scans and Glasgow Coma Score (GCS).
Purpose:
- To evaluate the outcomes of surgical intervention for spontaneous ICH in severely affected patients.
- To identify factors influencing survival rates in this patient cohort.
Summary:
- 34 patients with spontaneous ICH and severe consciousness disturbance underwent surgery.
- Indications for surgery were based on CT findings, GCS, and neurological status.
- Mortality rate was high (64.7%), with only 35.3% survival.
- Patients in deeper coma (GCS 3-5) had extremely poor outcomes, with only one young survivor.
- Survival was associated with less disturbed consciousness, absence of intraventricular bleeding on CT, and younger age.
Impact:
- Highlights the critical condition of patients undergoing surgery for spontaneous ICH.
- Suggests that surgical outcomes are significantly influenced by the depth of coma and age.
- Underscores the need for further research into optimizing treatment strategies for severe ICH.
Abstract:
There have been 34 patients with spontaneous intracerebral haematomas (ICH) operated, from the 1st January 2002. Yr to the 31st December 2002. Yr., at the Neurosurgical Department of Trauma Centre (Clinical Centre of Serbia). They all were with the serious disturbance of consciousness. For all these patients, indication for operation was established according to CT findings, state of consciousness, defined Glasgow Coma Score (GCS) and neurological state. Due to the established incarceration or its risk, none of these patients had angiography, so preoperatively we didn't know the reason of bleeding. From 34 operated patients, 22 or 64.7% died and 12 or 35.3% survived. There were 14 patients in the deepest state of coma, where preoperatively GCS score was 3 to 5. Only one patient age 25 survived postoperatively. Other survivors have less disturbed state of consciousness, CT findings without intraventricular bleeding and were also in younger age group.
