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Japanese

Functional Outcome of Primary Pontine Hemorrhage : Conservative Treatment or Stereotaxic Surgery Takayuki HARA 1 , Kazuya NAGATA 1 , Shunsuke KAWAMOTO 1 , Jun SASHIDA 1 , Tadashi ABE 1 , Akira WADA 1 , Tetsuya SAKAMOTO 2 1Department of Neurosurgery, Showa General Hospital 2Department of Emergency Medicine, Showa General Hospital Keyword: pontine hemorrhage , stereotaxic surgery , conservative treatment , functional outcome pp.823-829
Published Date 2001/9/10
DOI https://doi.org/10.11477/mf.1436902093
  • Abstract
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In this study we compared the outcome of patients with primary pontine hemorrhage (PPH) in those who underwent stereotaxic aspiration and those treated non-surgically. Out of 75 PPHs, 37 patients were selected. Their consciousness on admission was somnolent to semicoma (alert and deeply comatose cases were excluded). Patients admitted between 1988 and 1990, and between 1995 and 1996 underwent CT guided sterotaxic aspiration (18cases : Surgical Group), and those admitted between 1991 and 1994 were treated conservatively (19 cases : Conservative Group). The outcome was analyzed three months after the onset from the viewpoint of level of consciousness and severity of paresis, according to the location of the hemorrhage. With regard to consciousness, 13 of 18 cases in the Surgical Group showed remarkable im-provement, while only 8 of 19 cases in the Conservative Group did. The severity of paresis was evaluated only among the patients who could obey commands three months after the onset. Paresis improved in 7 of 13 patients in the Surgical Group, vs. in 3 of 8 patients in the Conservative Group (p<0.05). According to the location of hemorrhage (CT classification), in the Unilateral tegmental type and the Massive type, the Surgical Group and the Conservative Group showed no difference. On the other hand, in the Bilateral teg-mental type and the Basal tegmental type, surgery seemed to be more effective than conservative treat-ment. In conclusion, CT guided stereotaxic aspiration may improve not only the consciousness level but also the functional outcome.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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