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Journal of Korean Neurosurgical Society 1999;28(2): 237-245.
Stereotactic Evacuation of Spontaneous Intracerebral Hemorrhage.
Tae Goo Cho, Do Hyun Nam, Byung Moon Cho, Jung Il Lee, Jong Soo Kim, Seung Chyul Hong, Hyung Jin Shin, Kwan Park, Whan Eoh, Sang Do Bak, Mun Bae Chu, Jong Hyun Kim
Department of Neurosurgery, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.
The best treatment modality for spontaneous intracerebral hemorrhage still remains to be controversial. Stereotactic surgery can be performed safely and easily but its indication and optimal timing of operation have to be determined. We treated 80 patients with spontaneous intracerebral hemorrhage by stereotactic surgery from October 1994 to December 1997. We investigated clinical status of the patients before and after surgery, amount of hematoma, evacuation rate, timing of operation, transcranial Doppler sonography(TCD), and computerized tomography(CT) findings. The results were as follows: 1) The outcome of early surgery(within 24 hours of bleeding) was better than that of late surgery(after 24 hours of bleeding)(p=0.034). 2) The outcome was better in the patient with higher evacuation rate(p=0.014). 3) TCD monitoring showed beneficial effect of surgery on hemodynamic status. We conclude that the early surgery within 24 hours after bleeding is correlated with the better outcome, and TCD monitoring is useful for evaluation of perioperative hemodynamic change.
Key Words: Stereotactic hematoma evacuation; Spontaneous intracerebral hemorrhage; Transcranial Doppler sonography(TCD)
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