Treatment of Spontaneous Intracerebral Hemorrhage a Comparative Clinical Analysis of Stereotactic and Conservative Treatment

ABSTRACT

The treatment of patients with spontaneous intracerebral hemorrhage remains a matter of debate in neurosurgery and neurology. We analyzed 203 patients with spontaneous intracerebral hematoma and compared the result of treatment between two groups100 patients with stereotactic hematoma evacuation and 103 patients with conservative treatment. Evaluation of outcome was performed at discharge with Glasgow coma scale, motor deficit, Glasgow outcome scle. Stereotactic surgical patients with medium sized(20-50 cc) hematoma, which located in basal gaglia and thalamic area made a significantly better functional recovery than did patients with conservative treated group. Patients with relatively mild neurologic deficit preoperatively had better functional outcomes in the stereotactic surgical group. Stuporous or comatose patients had no better outcome after surgery, but showed a significantly lower mortality rate than conservative treated group. There was no significant difference in the outcome in relation to the timing of surgery, but rebleeding risk was high on early operated patients. Stereotactic surgery can minimized the brain damage and be performed under local anesthesia, so there was a trend toward better quality of survival and chance of survival in the operated group.