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KMID : 0359819950240030262
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Journal of Korean Neurosurgical Society
1995 Volume.24 No. 3 p.262 ~ p.271
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The Surgical Results of C-T Guided Sterotactic Early Aspiration with Urokinase Irrigation on Deep Seated Spontaneous Intracerebral Hemorrhage
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최영근
함인석/성주경/황성규/박연묵/김승래
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Abstract
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C-T guided stereotactic early burr hole aspirations performed on 106 spontaneous deep intracerebral hematoma patients in the Department of Neurosurgery. Kyungpook University Hospital. between January 1992 and December 1993. For average five days
following the operation. continual urokinase (UK) irrigation was done for complete removal of the remaining hematoma. Of the patients. 73 who were operated on within three days of bleeding ictus for analyses and evaluation by factors believed to
affect
the final results.
Eighty six percent was found to have hypertension as its cause. The hematoma was removed completely in 13.7% of all the patients on post operation lst day and 45% within 7 days by urokinase irrigation. The site of hematoma in
thalamocapsulo-lenticular
area showed a rather poor remission rate compared with those in other locations along with a higher mortality rate. By comparison between the time of admission and discharge. the state of consciousness of patients showed much improvement with
440%
of
the number of alert patients on discharge : motor function also showed significant improvement with 450% good patients number. In case of poor state of consciousness or motor function on admission. the mortality rate was higher. Rebleeding after
aspiration was found in 6.8% and in all the cases except one the operation was done within 24 hours of bleeeding, which resulted in poor postoperative outcome without improvement. Pneumonia was most common complication during admission followed
by
hydrocephalus. Mortality rate was 8.2%, most of which resulted from direct brain damage through bleeding.
This surgical method is simple, safe and efficient in treating spontaneous deep intracerebral hematoma with no significant outcome difference when compared with early craniotomy.
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