Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage - - - Hirurški ishod kod bolesnika sa spontanim supratentorijalnim intracerebralnim krvarenjem
Journal Title: Acta Facultatis Medicae Naissensis - Year 2017, Vol 34, Issue 4
Abstract
The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS). The surgical treatment was successful in 14 patients (37%), whereas it was unsuccessful in 24 patients (63%). We have detected a significant negative correlation between the Glasgow Coma Scale (GCS) scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding. - - - Cilj rada bio je procena hirurškog ishoda kod bolesnika sa spontanim supratentorijalnim intracerebralnim krvarenjem (ICH) nakon hirurške intervencije u odnosu na inicijalne kliničke uslove, starost, pol, stranu hemisfere i anatomsku lokalizaciju ICH. Studija je uključila trideset osam hirurški tretiranih bolesnika sa spontanim supratentorijalnim intracerebralnim krvarenjem. Hirurški ishod je procenjen tri meseca nakon inicijalnog prijema, prema rezultatima (Glazgorske skale ishoda GOS). Hirurški tretman je bio uspešan kod 14 bolesnika (37%), dok je kod 24 bolesnika (63%) bio neuspešan. Otkrili smo značajnu negativnu korelaciju između rezultata (Glazgorske skale kome GCS) na prijemu i rezultatima GOS-a nakon tri meseca, što ukazuje na lošiji neurološki ishod kod bolesnika sa početnim nižim rezultatima GCS-a. Na hirurški ishod kod bolesnika sa ICH nisu uticali pol, strana hemisfere i anatomska lokalizacija ICH, ali je starost bolesnika procenjena kao značajan faktor za njihov funkcionalni ishod, pri čemu je kod mlađih lečenje bilo uspešnije. Na hirurški ishod utiču početno kliničko stanje bolesnika kao i njihova starost. Lečenje ICH je i dalje je nerazjašnjen klinički problem i neophodno je razviti nove hirurške tehnike sa većom efikansošću u evakuaciji hematoma, čime se minimalno oštećuje normalno tkivo mozga, a smanjuje se i mogućnost postoperativnog krvarenja
Authors and Affiliations
Vladimir Rendevski, Dragan Stojanov, Boris Aleksovski, Ana Mihajlovska-Rendevska, Aleksandar Chaparoski, Doga Ugurlar, Vasko Aleksovski, Natalija Baneva, Icko Gjorgoski
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