ABSTRACT
The best treatment modality of spontaneous intracerebral hematoma is still controversial. But stereotactic surgery can minimize the brain damage and be performed under local anesthesia. Recently we experienced 46 cases of spontaneous intracerebral hematoma which were operated using ZD(Zamorano-Dujovny) stereotactic system and urokinase irrigation from November 1990 to April 1993. Before operation, computerized tomographic scanning was done to locate the hematoma, assess the amount, and to determine the stereotactic coordinates. The silastic tube was inserted after stereotactic evacuation of hematoma and urokinase irrigation was repeated every 6 to 8 hours until the hematoma was cleared up. The results were analysed and we concluded that we can substitute open craniectomy or conservative treatment for stereotactic evacuation of spontaneous intracerebral hematoma combined with urokinase irrigation in certain instances and can minimize the brain damage regardless the patient's general condition or past history.
Subject(s)
Anesthesia, Local , Brain , Cerebral Hemorrhage , Hematoma , Urokinase-Type Plasminogen ActivatorABSTRACT
The authors report one case of akinetic mutism with obstructive hydrocephalus. The patient suffered from multiple shunt failures and shunt revision. After multiple shunt revision, the patient fell into an akinetic-mute state. She appeared awake but was no response to painful somatosensory, loud auditory or threatening visual stimuli and she required total nursing care. This behavioral syndrome was no response to shunt revision but we were able to successfully treat a case of akinetic mutism after combination theraphy of Bromocryptine and Ephedrine.