Results of Stereotactic Evacuation of Hematoma and External Ventricular Drainage in Comatose Patients with Hypertensive Supratentorial Intracerebral Hemorrhage.

Hong, Seong Bong; Yu, Dae Jin; Song, Chin Kyu; Yang, Eui Joong; Jang, Suk Jung; Shin, Ho

Original Article

Journal of Korean Neurosurgical Society 1994;23(11): 1244-1252.

Seong Bong Hong, Dae Jin Yu, Chin Kyu Song, Eui Joong Yang, Suk Jung Jang, Ho Shin

Department of Neurosurgery, Chosun University Medical College, Kwangju, Korea.

ABSTRACT

The purpose of this study was to analyze and evaluate therapeutic results of stereotactic evacuation of hematoma, urokinase irrigation and external ventricular drainage(EVD) in comatose patients who had hypertensive supratentorial intracerebral hemorrhage. The authors carried out stereotactic evacuation of hematoma and external ventricular drainage in the consecutive 45 cases who were admitted to the Department of Neurosurgery, Chosun University Hospital. from Sep. 1990 to Jun. 1993. The therapeutic results were as follows : 1) The peak age incidences were 6th to 7th decades. The incidence was higher in female than male. The age was not related to the prognosis. 2) The hematoma was located at the basal ganglia in 37 cases, and the thalamic area in 8 cases. The prognosis was poorer as the area of hematoma extended more wider and deeper. 3) The volume of hematoma ranged from 8 to 155 ml. The prognosis of the patient was unfavorable in large volume of hematoma. 4) Intraventricular hemorrhage(IVH) occured in forty cases(89.9%) and mortality rate was 45%. The mortality rate was increased in cases with IVH than in case without it. 5) The mortality rates based on the Glasgow coma scale(GCS) on admission were 50% in GCS score 4 group, 50% in GCS score 5 group, 40% in GCS score 6 group, 27% in GCS score 7 group.
Case
s of low Glasgow coma scale on admission showed high mortality rate. 6) The overall mortality rate was 42%. These results suggest that stereotactic evacuation of hematoma and EVD decreased the mortality rate when compared with conservative treatment and conventional craniotomy in the literatures.

Key Words: Hypertensive intracerebral hemorrhage; Comatose patients; Stereotactic evacuation; External ventricular drainage