1307 Surgical versus conservative treatment in the management of spontaneous intracerebral hemorrhage in adults: a retrospective study

✓ Analysis of 150 postmortem examinations indicates that spontaneous intracerebral hemorrhage in hypertensive patients develops in two ways. In the first, hemorrhage crushes the surrounding tissue, tamponades the ventricles, and produces a fatal increase in intracranial pressure. Operation on such patients does not improve the results obtained by conservative treatment. In the second type, the hemorrhage is self-limited; the hematoma that frequently develops behaves as an expanding lesion, and operative treatment can be helpful after the initial shock interval has passed. Diagnostic differentiation of the two types is not possible immediately after the stroke.

Download Full-text

Predictors for recurrent spontaneous intracerebral hemorrhage: A retrospective study

Porto Biomedical Journal ◽

10.1016/j.pbj.2017.07.047 ◽

2017 ◽

Vol 2 (5) ◽

pp. 195

Author(s):

Catarina Castro Alves ◽

Hipólito Nzwalo ◽

Ana Marreiros

Keyword(s):

Retrospective Study ◽

Intracerebral Hemorrhage ◽

Spontaneous Intracerebral Hemorrhage

Download Full-text

Conventional Craniotomy Versus Conservative Treatment in Patients With Minor Spontaneous Intracerebral Hemorrhage in the Basal Ganglia

10.21203/rs.3.rs-137154/v1 ◽

2020 ◽

Author(s):

Ning Wang ◽

Xuanhao Zhu ◽

Qi Tu ◽

Daqian Zhu ◽

Shuai Qu ◽

...

Keyword(s):

Basal Ganglia ◽

Treatment Group ◽

Propensity Score ◽

Conservative Treatment ◽

Intracerebral Hemorrhage ◽

Propensity Score Matching ◽

Primary Outcome ◽

Clinical Status ◽

Spontaneous Intracerebral Hemorrhage ◽

Surgery Group

Abstract Background: The treatment for spontaneous intracerebral hemorrhage (ICH) is still controversial, especially for hematomas in the basal ganglia. A retrospective case-control study with propensity score matching was performed to compare the outcomes of conventional craniotomy and conservative treatment for patients with minor ICH in the basal ganglia.Methods: We retrospectively collected the data of consecutive patients with minor basal ganglia hemorrhage from January 2018 to August 2019. We compared clinical outcomes of two groups using propensity score matching. The extended Glasgow outcome scale obtained by phone interviews based on questionnaires at 12 months follow-up was used as the primary outcome measure. On the basis of their clinical status at admission, patients were divided into good and poor prognosis groups to obtain a dichotomized (favorable or unfavorable) outcome as the primary outcome. Secondary outcomes included hospitalized complications, mortality and modified Rankin score at 12 months.Results: A total of 54 patients were analyzed, and the baseline characteristics of patients in the surgery and conservative treatment groups were well matched. The primary favorable outcome at 12 months was significantly higher in the conservative treatment group than in the surgery group (81% vs 44%; OR 1.833, 95% CI 1.159–2.900; P=0.005). The incidence of pneumonia in the surgery group was significantly higher than that in the conservative treatment group (p=0.005).Conclusions: It is not recommended to undertake conventional craniotomy for patients with a minor hematoma (25–40 ml) in the basal ganglia. An open craniotomy might induce worse long-term functional outcomes than the conservative treatment.

Download Full-text