[Aspiration of hypertensive intracerebral hematoma by stereotactic technique (author's transl)]

Stereotactic aspiration of hypertensive intracerebral hematoma was performed in 10 patients. The patients selected for this operation had localized putaminal, thalamic hematoma and thalamic hemorrhages with ventricular penetration. The aspiration technique employed here could not remove the total hematoma, but did evacuate between half and two thirds of the volume estimated by CT scan. The target point determination was made by CT scan. In 6 patients with localized hematomas, the operation was carried out between 18 and 60 days after the hemorrhage. Three patients operated on between 18 and 26 days after the hemorrhage recovered markedly from hemiparesis and aphasia, while the remaining 3 patients operated on between 40 and 60 days showed no improvement in spite of the hematoma evacuation. In 4 patients with thalamic hemorrhage with ventricular penetration, continuous ventricular drainage was made as a first choice. About 2 weeks after starting the drainage, the remaining hematoma located in the thalamus was evacuated by the stereotactic technique. Marked improvement in consciousness and from aphasia were observed while there was a slight reduction in hemiparesis and sensory disturbance after surgery. Stereotactic method is only slightly traumatic, hence the technique described here may be indicated in patients with deep-seated hematomas, especially in the thalamus.