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Evaluation of CT-guided Stereotactic Hematoma Aspiration in Mild Cases with Putaminal Hemorrhage Yoshitaka OKIMURA 1 , Junichi ONO 1 , Yasuo IWADATE 1 , Hirohide KARASUDANI 1 , Sumio SUDA 1 , Katsumi ISOBE 1 1Department of Neurosurgery, Kimitsu Central Hospital Keyword: Mild putaminal hemorrhage , CT-guided stereotactic aspiration , Neuropsychological evaluation , Perifocal edema , Cerebral blood flow pp.611-617
Published Date 1991/7/10
DOI https://doi.org/10.11477/mf.1436900284

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  • Abstract
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Abstract

Reported here is the effectiveness of surgical man-agement in mild cases with putaminal hemorrhage (neu-rological grading 1 or 2, described by Kanaya, et al.).

Ten cases were treated by CT-guided stereotactic hematoma aspiration (aspiration group) , and another 10 cases were treated by only medical therapy (conser-vative group) . The mean interval from the onset to op-eration was. 7.2 clays. In both groups, serial change in the motor function of the upper extremity was ex-amined and the neuropsychological function was also evaluated at 2 weeks after onset. Perifocal low-density area around the hematoma was estimated on CT scan at 2 weeks after onset. Mean hemispheric cerebral blood flow (mCBF) was measured at 5-clays, 2 weeks and 6 months after onset, respectively in each group. The activity of daily life (ADL) was evaluated at 6 months after onset.

There was no statistically significant difference in age, neurological grading and CT findings on admis-sion between the 2 groups. At 2 weeks after onset, no case had deteriorated in motor function in the aspira-tion group. On the other hand, 2 cases had deteriorated in the conservative group. The neuropsychological function was considerably improved in the majority of cases in the aspiration group. Perifocal low area was significantly narrow on CT scan in the aspiration group. At 2 weeks after onset, the mCBF of the affected side was 53.8 ± 6.0 ml/100g/min in the aspi-ration group, whereas it was 42.0 ± 5.7 ml1/100g/min in the conservative group. This difference was statisticallysignificant. In spite of these favorable results in the aspiration group, the ADL at 6 months after onset was the same in both groups (ADI. I & II : 70%).

These results suggested that CT-guided stereotactic hematoma aspiration might be effective during theacute and subacute stage in the managment of mild cases with putaminal hemorrhage. The authors expect early ambulation in these cases, and a shorter hospita-lization period by this management.


Copyright © 1991, 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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