scholarly journals Keyhole Evacuation for moderate basal ganglia Hematoma superior than Craniotomy

2020 ◽  
Author(s):  
Lu Peng ◽  
Qing Zhu ◽  
Qing Lan ◽  
Yuan Cheng ◽  
Guodong Liu
Keyword(s):  
Basal Ganglia ◽  
Mortality Rate ◽  
Intracerebral Hemorrhage ◽  
Infection Rate ◽  
Surgical Procedures ◽  
Operation Time ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Hospitalization Cost ◽  
Keyhole Surgery ◽  
Evacuation Rate

Abstract Background: Spontaneous intracerebral hemorrhage (SICH) is the most devastate kind of stokes.For basal ganglia hematoma with volume ranged from 30 to 60 ml, different surgical procedures have been recommended by different neurosurgeons.This study aimed to compare the clinical outcomes and hospitalization cost between keyhole surgery and craniotomy for basal ganglia intracerebral hemorrhage.Methods: A retrospective analysis was performed on clinical data of 63 cases of keyhole procedure and 56 cases of craniotomy procedure. Hematoma evacuation rate, infection rate, re-bleeding, operation time, hospitalization cost and outcome were recorded.Results: The evacuation rate was similar in keyhole group and craniotomy group (P>0.05), and infection rate was lower in keyhole group compared to craniotomy group (P<0.05). Mean operation time and hospitalization cost were less in keyhole group than in craniotomy group (P<0.05). Mortality rate between two groups showed no significant differences. The patients operated within 6h had better outcome than those operated between 6-24h (p<0.05).Conclusion: For patients with basal ganglia hematoma ranged from 30-60 ml, keyhole surgery is safe and feasible, and operation within 6 h can improve the prognosis of the patients.

Intracranial Hypertension After Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-analysis of Prevalence and Mortality Rate

2018 ◽  
Vol 31 (1) ◽  
pp. 176-187 ◽  
Author(s):  
Daniel Agustín Godoy ◽  
Rafael A. Núñez-Patiño ◽  
Andres Zorrilla-Vaca ◽  
Wendy C. Ziai ◽  
J. Claude Hemphill
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Intracerebral Hemorrhage ◽  
Intracranial Hypertension ◽  
Meta Analysis ◽  
Spontaneous Intracerebral Hemorrhage

Impact of ischemic heart disease and atrial fibrillation on survival after spontaneous intracerebral hemorrhage

2008 ◽  
Vol 108 (6) ◽  
pp. 1172-1177 ◽  
Author(s):  
Sami Tetri ◽  
Liisa Mäntymäki ◽  
Seppo Juvela ◽  
Pertti Saloheimo ◽  
Juhani Pyhtinen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Mortality Rate ◽  
Intracerebral Hemorrhage ◽  
Ischemic Heart Disease ◽  
Mortality Rates ◽  
Ischemic Heart ◽  
University Hospital ◽  
Spontaneous Intracerebral Hemorrhage

Object The well-known predictors for increased early deaths after spontaneous intracerebral hemorrhage (ICH) include the clinical and radiological severity of bleeding as well as being on a warfarin regimen at the onset of stroke. Ischemic heart disease and atrial fibrillation may also increase early deaths. In the present study the authors aimed to elucidate the role of the last 2 factors. Methods The authors assessed the 3-month mortality rate in patients with spontaneous ICH (453 individuals) who were admitted to the stroke unit of Oulu University Hospital within a period of 11 years (1993–2004). Results The 3-month mortality rate for the 453 patients was 28%. The corresponding mortality rates were 42% for the patients who had ischemic heart disease and 61% for those with atrial fibrillation on admission. The following independent predictors of death emerged after adjustment for sex and the use of warfarin or aspirin at the onset of ICH: 1) ischemic heart disease (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.12–2.48, p < 0.02); 2) atrial fibrillation on admission (HR 1.79, 95% CI 1.12–2.86, p < 0.02); 3) the Glasgow Coma Scale score on admission (HR 0.82 per unit, 95% CI 0.79–0.87, p < 0.01); 4) size of hematoma (HR 1.11 per 10 ml, 95% CI 1.07–1.16, p < 0.01); 5) intraventricular hemorrhage (HR 2.62, 95% CI 1.71–4.02, p < 0.01); 6) age (HR 1.04 per year, 95% CI 1.02–1.06, p < 0.01); and 7) infratentorial location of the hematoma (HR 1.93, 95% CI 1.26–2.97, p < 0.01). Conclusions Both ischemic heart disease and atrial fibrillation independently and significantly impaired the 3-month survival of patients with ICH.

Tissue Damage at Computed Tomography following Resolution of Intracerebral Hematomas

1986 ◽  
Vol 27 (5) ◽  
pp. 495-500 ◽  
Author(s):  
E. B. Skriver ◽  
T. S. Olsen
Keyword(s):  
Computed Tomography ◽  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Contrast Enhancement ◽  
Tissue Damage ◽  
Intracerebral Hematoma ◽  
Ventricular Enlargement ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Adjacent Structures ◽  
Area 6

Tissue damage as sequelae after spontaneous intracerebral hemorrhage in eight consecutive patients was investigated with computed tomography performed 3 days, 2 weeks and 6 months after the stroke. The presence of contrast enhancement after 2 weeks, hypodense areas after 6 months, and atrophy of adjacent structures were considered to be markers of irreversible tissue damage. Except for a narrow zone in the periphery of the hematoma (ring blush) contrast enhancement was not observed, neither in the hematoma nor in areas where resolution had taken place. After 6 months the site of the hematomas was not identifiable in 3 patients, and 4 patients had small ‘lacunar’ hypodense lesions. Only one patient had a more extensive hypodense area 6 months after the hemorrhage. The most prominent sequelae after intracerebral hematoma were atrophy of adjacent structures (i.e. atrophy of basal ganglia, thalamus and ventricular enlargement) which were seen in all patients even though irreversible de loco damage in the hematoma area was sparse or absent.

Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage

1993 ◽  
Vol 78 (2) ◽  
pp. 188-191 ◽  
Author(s):  
Joseph P. Broderick ◽  
Thomas Brott ◽  
Thomas Tomsick ◽  
Rosemary Miller ◽  
Gertrude Huster
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Intracerebral Hemorrhage ◽  
Annual Incidence ◽  
Laboratory Research ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Content Type ◽  
Fine Print

✓ The authors report a study of all instances of spontaneous intracerebral hemorrhage (ICH) (188 cases) and subarachnoid hemorrhage (SAH) (80 cases) that occurred in the Greater Cincinnati area during 1988. Adjusted for age, sex, and race, the annual incidence of ICH was 15 per 100,000 population (95% confidence interval 13 to 17) versus six per 100,000 for SAH (95% confidence interval 5 to 8). The incidence of ICH was at least double that of SAH for women, men, and whites and approximately 1½ times that for blacks. The 30-day mortality rate of 44% for ICH was not significantly different from the 46% mortality rate for SAH. Despite the evidence that ICH is more than twice as common and the disorder just as deadly as SAH, clinical and laboratory research continues to focus primarily on SAH.

scholarly journals The natural course of spontaneous intracerebral brain hemorrhage localized in the basal ganglia of the brain: The analysis of a series of 39 patients

2014 ◽  
Vol 61 (4) ◽  
pp. 17-20
Author(s):  
Aleksandra Milosevic ◽  
Nikola Repac ◽  
Igor Nikolic ◽  
Igor Coric ◽  
Aleksandar Janicijevic ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Cerebrovascular Diseases ◽  
Age Group ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Male Patients ◽  
One Year ◽  
The Moment ◽  
Special Hospital ◽  
The Brain

The study included 39 patients treated in a Special hospital for the prevention and treatment of cerebrovascular diseases ? Sveti Sava? in Belgrade in the period from October 2010 to January 2012. The criteria for inclusion in the study is the moment of diagnosis of spontaneous intracerebral hemorrhage (ICH) in the basal ganglia of the brain (BG). The results: we analyzed 25 male patients and 14 female patients, aged 54 years to 95 years. In deceased group - 22 (56.4%), 20 (90.9%) were the age group 60 to 80 years., GCS: 3-5 -12 patients (54.5%) died, GCS 6 -8 -10 patients (45.5%), 20 patients (90.9%) also had intracerebral and intraventricular hemorrhage complicated by acute hydrocephalus. Conclusion: predisposing factors for mortality within one year in patients with spontaneous intracerebral hemorrhage in the basal ganglia of the brain are: males older than 60 years, unregulated hypertension and penetration of blood in the chamber system.

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

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.

Spontaneous intracerebral hemorrhage due to coagulation disorders

2003 ◽  
Vol 15 (4) ◽  
pp. 1-17 ◽  
Author(s):  
Alfredo Quinones-Hinojosa ◽  
Mittul Gulati ◽  
Vineeta Singh ◽  
Michael T. Lawton
Keyword(s):  
Risk Factor ◽  
Mortality Rate ◽  
Intracerebral Hemorrhage ◽  
Intracranial Hemorrhage ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bleeding Disorders ◽  
Coagulation Disorders ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Comprehensive Review

Although intracranial hemorrhage accounts for approximately 10 to 15% of all cases of stroke, it is associated with a high mortality rate. Bleeding disorders account for a small but significant risk factor associated with intracranial hemorrhage. In conditions such as hemophilia and acute leukemia associated with thrombocytopenia, massive intracranial hemorrhage is often the cause of death. The authors present a comprehensive review of both the physiology of hemostasis and the pathophysiology underlying spontaneous ICH due to coagulation disorders. These disorders are divided into acquired conditions, including iatrogenic and neoplastic coagulopathies, and congenital problems, including hemophilia and rarer diseases. The authors also discuss clinical features, diagnosis, and management of intracranial hemorrhage resulting from these bleeding disorders.

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