| Considerations for the Factors Affecting Rebleeding when Performing Stereotactic Aspiration as the Main Treatment of Spontaneous Intracerebral Hematoma |
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Cheon Wook Park, Young-Cho Koh, Joon Cho |
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Department of Neurosurgery, KonKuk University School of Medicine, Seoul, Korea |
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| Abstract |
Objective
Stereotactic aspiration is known to be a relatively safe method of removing intracerebral hematomas (ICH). However,
recurrent bleeding that develops after stereotatic aspiration of ICH remains an important unsolved problem. The rate of rebleeding
was 16% according to the study carried out by E. I. Kandel and V. V. Peresedov, and this is thougt to be due to formation of negative pressure in the cavity after aspiration.
Methods
A retrospective study was carried out in all ICH patients who underwent stereotactic aspiration or who were treated
medically in our hospital during January, 2009 and May, 2012. They were divided into groups A and B, depending on the occurrence of rebleeding. Their clinical status and prognosis were not considered in this study. Rebleeding was evaluated with computed tomography (CT) image, and the hematoma volume was calculated by the formula A×B×C/2.
Results
Out of 156 patients in total, 110 patients categorized into group A did not experience rebleeding. In 46 patients who
experienced rebleeding and included in group B. 27 patients (24.55%) were underwent stereotactic aspiration in group A while 13
(28.26%) underwent stereotactic aspiration in group B. Rebleeding rate in regards to surgery showed p-value of 0.628, and was
shown to have no statistical significance. The rebleeding rate was shown to have high association with the patient’s bleeding tendency and the initial volume of hematoma.
Conclusion
Stereotactic aspiration of ICH can be said to be safer than the classic open removal, and has no significantly higher
rebleeding rate in comparison with medical treatment. When deciding treatment plans in ICH patients, the volume of hematoma
and the patient’s bleeding tendency should be considered as the more important factor. |
| Key Words:
Spontaneous intracerebral hematoma, Stereotactic aspiration, Rebleeding. |
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