ABSTRACT
Background: Management of spontaneous supratentorial hemorrhage via conservative management is controversial so our study aimed to compare between conservative and surgical treatment of spontaneous supratentorial hemorrhage. Methods: 90 patients were selected who were diagnosed with spontaneous supratentorial hemorrhage and had given written consent to participate in the study. Patients were randomly divided into two groups of early surgery group (n=45) and conservative group (n=45). Results: 90 patients with spontaneous supratentorial hemorrhage were analysed who fulfill the inclusion criteria . Both the groups were comparable with respect to age , sex, medical comorbidities, Glassgow coma score. The intraventricular hemorrhage were present in 31.1% in conservative group and 26.6% in surgical group (but no significant difference as p value 0.641). Outcome of patients was analyzed by Glasgow outcome score and modified Rankin score. There was also no significant difference in mRS of conservative and surgical group (p value -0.206). Mortality at 3 months was 31.1% in conservative group and 40% in surgical group (p value 0.378).For patients less than and equal to 55 years age group both the groups were comparable and there was no stastically significant difference between conservative and surgical groups as Glassgow outcome scale and Modified rankin score values were comparable. But for patients more than 55 years age group. Good outcome as measured by Glassgow outcome score(p value is 0.037) and Modified Rankin score(p value 0.038) was significantly more in conservative group as compare to surgical group. Conclusion: In our study, we found no significant difference in outcome between conservative and surgical management of primary spontaneous suprtentorial hemorrhage. But interestingly, for more than 55 age group, outcome of conservative management was better than surgical management. But there is no significant difference in mortality between conservative and surgical management for any age group.