The Relation Between Surgically Treated Spontaneous Intracerebral Hematomas and Mortality: Retrospective Evaluation of 72 Cases
Mete Karatay, Reyhan Mehmetoğlu, Yavuz Erdem, Bülent Gülensoy, Tuncer Taşcıoğlu, İdris Sertbaş, Mehmet Akif Bayar
Department Of Neurosurgery, Ministry Of Health Ankara Training And Research Hospital, Ankara
Keywords: Intracerebral hematoma, Surgical treatment, GCS (Glasgow Coma Scale), Mortality
Abstract
OBJECTIVE: In this study we investigated the relationship between mortality and factors in the surgical treatment of spontaneous intracerebral hematoma in cases presented to our clinic.
METHODS: 72 cases of spontaneous intracerebral hemorrhage with non-traumatic intracerebral hemorrhage presented between the years 1997-2009 which underwent surgical treatment were evaluated retrospectively.
RESULTS: Among the 72 cases, 41 (57%) were males, and 31 (43%) were females. The etiology in 52 (72%) of the cases was hypertension. Regarding the location of the hematoma, 27 (37%) of the cases were lobar, 30 cases (41%) were thalamic, 13 (18%) were cerebellar and 2 cases (4%) were in the putaminal location. The mortality rate in cases that received surgery within the first 8 hours was 41% (18 cases), and the rate was 61% (14 cases) in patients that received surgery between 8-24 hours. If the surgery was received between 24-48 hours following the initial hematoma, the mortality rate was 80% (4 cases).
CONCLUSION: In spontaneous intracerebral hematoma cases, surgical treatment that is performed following consideration of the initial neurological examination, age, volume of hematoma, its localization, and time until surgery reduces the mortality. Clinically, there is no advantage of surgical treatment over the medical treatment in cases with poor neurological grade.