STEREOTACTIC COMPUTED TOMOGRAPHIC-GUIDED ASPIRATION AND THROMBOLYSIS OF INTRACEREBRAL HAEMATOMA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 42
Abstract
BACKGROUND Spontaneous intracerebral haemorrhage produces devastating neurological disability and is by far the most untreatable form of stroke. ICH is mainly managed medically. To date there are no studies to prove that surgery has better outcome in deep scattered ICH than medical treatment alone. Stereotactic aspiration of haematoma and urokinase treatment is a minimally invasive method, which gives excellent radiological and good clinical outcome. This procedure is simple, less expensive and less invasive than formal craniotomy. MATERIALS AND METHODS We present our experience on 140 patients in whom stereotactic aspiration and urokinase instillation for spontaneous deep intracerebral haemorrhage was done. We have chosen a group of patients having deep ICH, i.e. in basal ganglia and thalamic region. We have increased the dose and frequency of urokinase instillation than previous studies. We have included patients who are even GCS 3 and 4. All our patients had haematoma size more than 30 cc. ICH score of majority of our patients was 3 and 4, in whom expected mortality was 72 and 97% respectively. It was observed that clearance of haematoma was as good as surgical evacuation on CT scan and many patients did show good improvement. We present our clinical data with observations during admission and follow-up period of these patients. RESULTS ICH is the most dreaded form of stroke. We have a prejudice that these patients are not going to do well. As per literature, there is more than 50% mortality and only 20% of survivors are ALD independent at the end of six months. CONCLUSION We have got very encouraging results. Stereotactic aspiration and urokinase is simple and effective method for treatment of spontaneous deep intracerebral haemorrhage.
Authors and Affiliations
Sunil Yadav, Vinayak Raje, Trishant Chotai, Devdutta Patil, Rahul Kumar
Keywords
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- EP ID EP548516
- DOI 10.14260/jemds/2018/1011
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