[Emergency management of intracerebral hematoma of nontraumatic origin]

A series of 78 consecutive non-traumatic intracerebral hematomas operated upon between 1972 and 1981 is presented; the authors analysed the etiology, age, sex, clinical manifestation and state of consciousness as well as timing of surgery as factors potentially influencing the outcome. The mortality rate before introducing of C. T. scan (before 1978) as a main diagnostic procedure, was over 50% and decreased to 25% after its use. Patients operated on in the first 24 hours after the bleeding, have mortality of 50%, on the second day 16%, and since the third day there was no mortality. The mortality rate in patients with moderate neurological deficiencies and slight disturbances of consciousness was under 10%, reached full 91% in patients with severe neurological deficiencies and deep coma. The etiology as a possible factor determining the outcome in non-traumatic intracerebral hematomas is also analysed and discussed. In patients with AVM as a cause of compressive hematoma there was no mortality, while in hematomas due to aneurysmal rupture, mortality was over 42%. Mortality in hypertensive patients was 53% and in spontaneous hematomas it was 35%.