Subacute stereotactic aspiration of haematomas within the basal ganglia reduces occurrence of complications in the course of haemorrhagic stroke in non-comatose patients.
OBJECTIVE
Medical complications occurring after stroke of both ischaemic and haemorrhagic origin are frequent and constitute an important problem. The strongest factor predicting the occurrence of complications is known to be the initial neurological impairment level. The aim of this study was to examine whether subacute stereotactic aspiration of haematomas within the basal ganglia is suitable to reduce the occurrence of complications in the course of haemorrhagic stroke in non-comatose patients.


METHODS
Following rigorous selection criteria, 56 consecutive non-comatose patients were treated by subacute stereotactic evacuation of the haematomas. Glasgow Coma Scale (GCS) scores after initiation of treatment, medical complications, mortality and length of in-patient stay before discharge for further rehabilitative treatment were recorded for each patient and were compared with the results obtained in a comparable group of 39 patients treated purely medically in another hospital.


RESULTS
The level of consciousness improved markedly after stereotactic surgery, and GCS scores were significantly higher than those after pure medical treatment (p < 0.0001). In comparison with medical patients, complications were considerably fewer in the surgical group, and thus peri-ictal morbidity and mortality were significantly lower. Length of necessary treatment in the intensive care unit as well as total in-patient stay in the acute care facility were significantly reduced.


CONCLUSIONS
Improving alertness, subacute stereotactic aspiration of deep-seated haematomas decreases occurrence of medical complications in the course of haemorrhagic stroke. Recovery can be accelerated, and patients are earlier suitable for further rehabilitative treatment.
Marquardt
Gerhard
G
Neurosurgical Clinic, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. G.Marquardt@em.uni-frankfurt.de
Wolff
Robert
R
Sager
Anke
A
Janzen
Rudolf W C A
RW
Seifert
Volker
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020145:Basal Ganglia Hemorrhage / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D003128:Coma / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care; D013238:Stereotaxic Techniques; D020521:Stroke / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D019467:Subacute Care / Q000379:methods*; D013396:Suction / Q000379:methods*; D015996:Survival Rate