Surgical management of spontaneous intracerebral hemorrhage

Alkhadrawy, Shehab M; Alaghory, Islam; Selim, Mahmoud M.

doi:10.4103/sjamf.sjamf_66_18

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…It has been reported that SICH is most commonly located in the basal ganglia (50%-60%) 16. Consistent with this study, hematomas were most commonly localized in the deep region in our study (37 patients [69.8%]).…”

Section: Discussionsupporting

confidence: 92%

Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Kıyak

2024

Dicle Tıp Dergisi

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Objective: In this study, we aimed to contribute to the literature by determining data such as mortality rates, demographic, clinical and radiological characteristics of patients who applied to our hospital's emergency department between January 2011 and December 2020 with the diagnosis of SISH and were operated on in our clinic. Methods:53 patients who were operated on for SISH diagnosis between January 2011 and December 2020 were retrospectively examined. Patients with SISH on brain tomography (CT) were evaluated. Hematoma localization is lobar; those with frontal, parietal, temporal and occipital locations; Those in the thalamic, putaminal and basal ganglia were considered to be deeply located. Patients were divided into three groups according to the Glasgow coma score (GCS): GCS 5–8, GCS 9–12, and GCS 13–15. Results: In our cohort, the patients mean age was 62.8 years (range, 19–92). The overall mortality rate was 62.87%. Age showed no significant association with mortality. Mortality was associated with increased hematoma volume and low GCS score at the first presentation (p < 0.001). In receiver operating characteristic curve analysis, hematoma volume was an important predictor of surgical outcome; the optimal cut-off value of 59.5 cm3 was associated with 84.4% sensitivity and 90.5% specificity (p < 0.001). Similarly, the optimal GCS score cut-off value of 8.5 was associated with a 96.9% sensitivity and 71.4% specificity for predicting mortality (p < 0.001). Conclusions:Low GCS, increased hematoma volume, and especially the presence of concomitant hypertension (HT) are associated with poor prognosis in SISH patients.

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Section: Discussionsupporting

confidence: 92%

Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Kıyak

2024

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“…In contrast to Alkhadrawy et al, (10) study, he concluded that The basal ganglia is the most common site of ICH, representing 50-60% of spontaneous ICH, and basal ganglia ICH is associated with 50% mortality rate. In our study ICH occurred in basal ganglia in 55%.…”

Section: Discussionmentioning

confidence: 72%

“…The best candidates for ICH evacuation are those with hematoma volume 30-60 ml and GCS more than 10. [10] While patients with poor GCS at presentation and pupillary inequality suggests greater primary brain injury and herniation leading to prolonged ventilator support. Most of these patients end up in vegetative state.…”

Section: Outcome Of Surgical Evacuation Of Spontaneous Supratentorial...mentioning

confidence: 99%

Outcome of surgical evacuation of spontaneous supratentorial Intra cerebral hemorrhage (ICH)

Hamada,

Hammam,

Omar

et al. 2022

Benha Journal of Applied Sciences

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Background: Spontaneous, nontraumatic intracerebral hemorrhage (ICH) remains a significant cause of morbidity and mortality throughout the world. Although ICH has traditionally lagged behind ischemic stroke and aneurysmal subarachnoid hemorrhage in terms of evidence from clinical trials to guide management, the past decade has seen a dramatic increase in studies of ICH intervention. The aim of the present study was to evaluate the survival and functional outcome after surgical evacuation of spontaneous supratentorial intra cerebral hemorrhage and factors affecting prognosis. Methods: This is a prospective study for 50 consecutive patients admitted to neurosurgery department in Benha university Hospital suffering from spontaneous intra cerebral hemorrhage (ICH) in ER where examination was done including the general examination, neurological and other systems. Initial CT brain scan was done on admission by evaluation of size of hematoma, site , midline shift , presence of intra ventricular extention. Results: According to Mortality rate, 10 (20%) patients died within average of 7.5 days after surgery ranged between 0 to 13 days . their initial GCS before surgery was 5 in four cases and 6 in 6 cases which worsen after surgery. Survived cases needed average of 2.92± 1.03 days to be fully conscious ranged between 2 to 5 days. mRS distribution in all studied group after 6 months of surgery was varied between 0 to 6 as 0 grade means no residual symptoms in 2 (4%) patient while 4 (8%) patients showed grade 1 no significant disability, 10 (20%) patients showed grade 2 slight disability, 20 (40%) patients showed grade 3 moderate disability and 10 (20%) showed grade 6 which means dead cases. There was statistically significant difference between Mean GCS before and after surgery (p = < .0001) as it was 9.04 and improved to 11.56 before leaving hospital. The mean mRS after surgery and before leaving the hospital was 3.72 ± 0.91 ranged between 1 to 5 while after 6 months the mean improved to 3.2 after 6 months with a statistically significant difference (p = 0.0013). Conclusion: Craniotomy and evacuation of spontaneous supratentorial ICH in patients with good premorbid status and moderate to good GCS even with big sized hematoma (more than 50 ml) have better long-term functional outcome. A combination of surgery and neurocritical care can result in favorable clinical outcome, regardless of ICH size or location.

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Surgical management of spontaneous intracerebral hemorrhage

Cited by 2 publications

References 16 publications

Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Outcome of surgical evacuation of spontaneous supratentorial Intra cerebral hemorrhage (ICH)

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