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Published on: December 13, 2017
[CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas]
1Navy General Hospital of People's Liberation Army, Beijing.
Insights
CT-guided stereotaxic evacuation effectively removed hypertensive intracerebral hematomas in 50 patients. This minimally invasive technique showed good operative results with varying degrees of neurological disability and mortality.
Area of Science:
- Neurosurgery
- Radiology
- Neurology
Background:
- Hypertensive intracerebral hematomas pose significant morbidity and mortality.
- Surgical intervention is often necessary to evacuate these hematomas.
- CT-guided stereotaxic techniques offer a minimally invasive approach.
Observation:
- Fifty patients with hypertensive intracerebral hematomas underwent CT-guided stereotaxic evacuation.
- Hematoma locations included basal ganglia, internal capsule, thalamus, cerebellum, and brain stem.
- Hematoma volumes ranged from <10 ml to >100 ml.
Findings:
- Complete aspiration of liquid hematomas was achieved in 9 patients.
- Over 80% of clot was evacuated in 28 patients, and 60-80% in 13 patients.
- Good operative results were observed in 28% of patients, with mild to marked neurological disability in 62% and a 10% mortality rate.
Implications:
- CT-guided stereotaxic evacuation is a viable option for managing hypertensive intracerebral hematomas.
- The technique allows for significant clot removal, potentially improving patient outcomes.
- Further research is warranted to optimize patient selection and procedural techniques to minimize neurological deficits and mortality.
Abstract:
CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas was performed in 50 patients. Hematoma was found in the basal ganglion in 36 cases in the internal capsule in 23, in external capsule in 6, in thalamus in 7, in subcortex in 6 in cerebellum, in 6 and in brain stem in 2. The volume of these hematomas was less than 10 ml in 2 patients, 20-50 ml in 21, 51-100 ml in 16 and over 100 ml in 11. The liquid hematoma was totally aspirated by stereotaxic technique in 9 patients. Similarly, more than 80% of clots of hematoma was evacuated in 28 patients and about 60-80% of clots was evacuated in 13. Good operative results were obtained in 14 patients (28%). Mild neurological disability was seen in 16 patients (32%) and marked disability in 15 (30%). Five patients (10%) died.
