[Intracerebral hematoma surgically treated under x-ray computed tomography with Backlund's needle. A series of 15 cases].
15 cases of supratentorial intracerebral hematomas (12 cases of primary hematomas and 3 post-traumatic cases) were operated under C.T. scan control, using the screw and suction technique (Backlund's needle). 10 cases of primary hematomas were operated early, before the 24th hour. The patients were selected for intervention on the following criteria: 1) Patients aged less than 70 years old; 2) initial Glasgow coma scale between 6 and 10; 3) cases with involvement of the mesencephalon by the hematoma were excluded. In the 3 cases of post-traumatic hematomas, intervention was decided in reference to the clinical course. The volume of the hematomas ranged from 40 to 160 cc. Putaminal or thalamic hematomas were observed in 9 cases. The percentage of aspirated hematoma volume ranged from 50 to 91%, the average being 70.5%. Dramatic improvement of the consciousness was observed in all cases. Improvement of the motor deficit was incomplete, for the most part. 1 patient rebled and 1 patient died (6.6% mortality). In 26% of the cases (4 patients) the development of a brain oedema, in the surrounding of the residual hematoma site, was observed during the post operative follow up. There was no post operative infection. Intervention under direct C.T. control allows an accurate guidance of the needle. Efficacity of the evacuation is attested by an immediate improvement of the mass effect on C.T. scan. Under C.T. control the risk to aspirate the adjacent brain is avoided. The technique proposed here has been easily performed in emergency condition.
Nguyen
J P
JP
Service de Neurochirurgie, Hôpital Henri Mondor, Créteil.
Gaston
A
A
Brugieres
P
P
Nallino
J
J
Rostaing
S
S
Decq
P
P
Leguerinel
C
C
Keravel
Y
Y
D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D003072:Cognition Disorders / Q000209:etiology; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D014207:Trephining / Q000295:instrumentation