New Concepts for Surgical Management of Spontaneous Intra-Cerebral Hematomas

Document Type : Original Article

Authors

Department of neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Spontaneousintracerebral hemorrhage (ICH) represents cerebral parenchymal bleeding that may also extend into ventricular, and rarely, subarachnoid space. ICH, as a stroke subtype, is associated with poor neurological outcome as well as high mortality (about 40% per month). ICH can be classified as either primary or secondary, depending on the underlying cause of bleeding. Objective: This study was aimed to represent criteria for surgical management for spontaneous intracerebral hematomas. Patients and Methods: This study included a total of 30 subjects, both sexes, aged 19-80 years with variable sizes and sites of spontaneous intracerebral hematomas. Conscious level and functional disabilities were measured by the neurological examination, Radiological evaluation was done pre, early post-operative and a month later to evaluate: the evacuation of the hematoma, monitoring the hemostatic measures done intraoperative to prevent re-collection of the hematoma in presence of different co- morbidities like HTN, coagulopathy, … etc. Results: Statistics revealed significant improvement in subjects operated with GCS ≥ 8, with motor power deficit G 0 , clear chest , age below 60 years old (P>0.001). Conclusion: Patients with spontaneous intracerebral hematomas showing good prognosis in patients below 60 years old, with clear chest complaining of motor power deficit G 0, with GCS≥ 8.

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