Stereotactic Aspiration for Massive Spontaneous Intracerebral Hemorrhage

Park, Min; Shin, Dong Gyu; Gong, Tae Sik; Kim, Hyo Joon; Lee, Yong Woo; Shin, Wooram

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2015;11(2):84-89.
Published online September 30, 2015.

Stereotactic Aspiration for Massive Spontaneous Intracerebral Hemorrhage

Min Park, Dong Gyu Shin, Tae Sik Gong, Hyo Joon Kim, Yong Woo Lee, Wooram Shin

Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea

Abstract

Objective
Spontaneous intracerebral hemorrhage (sICH) has variable prognosis and high prevelence. Most of the large-volume hematoma have poor prognosis. Surgical treatments of sICH include decompressive craniectomy and stereotactic aspiration. Decompressive craniectomy has been widely used for large-volume intracerebral hematomas. A limited number of studies have been conducted on the effectiveness of stereotactic aspiration in massive sICH. We studied the effectiveness of stereotaxic aspiration in patients with massive SICH.
Methods
This study included 44 patients with supratentorial ICH ≥50mL between January 2010 and December 2014. We retrospectively analyzed a 30-day mortality, changes in Glasgow comascale (GCS), changes in hematoma volume in patients who underwent stereotactic aspiration. And for a thesis that performed a simple comparison of mortality rates, the latest thesis that conducted a meta-analysis on sICH patients who underwent craniotomy and hematoma removal was selected.
Results
The mean hematoma volumes were 80.3mL in the stereotactic aspiration group (n=44). The 30-day mortality rates were 9.1% in the stereotactic aspiration group. The mortality rates of patients with a Glasgow coma scale (GCS) score of ＞9 were 5.9%. Postoperative complications, such as acute subdural hemorrhage, hemorrhage around the catheter, hydrocephalus, and rebleeding, occurred in 15.9%, respectively. Hemorrhage expansion was observed in 22.7% of patients.
Conclusions
The results of this study suggest that patients with intracerbral hemorrhage ≥50mL may have a better improvement in a lower 30-day mortality rate following stereotactic aspiration.

Key Words: Hypertensive intracerebral hemorrhage, Stereotaxic technique, Decompressive Craniectomy, Operative surgical procedures/mortality, Treatment effect.