Ultrasound-guided evacuation of spontaneous intracerebral hematoma in the basal ganglia.
Real-time ultrasonography was used for the aspiration of intracerebral hematoma in the basal ganglia in 7 patients without signs of impending herniation. The ultrasound device was used to select the trajectory and target point for hematoma drainage. Ultrasound-guided aspiration was performed via a burr hole under local anesthesia. We used a temporal burr hole entry point rather than the more frequently used pre-coronal approach. The burr hole was positioned 4 to 6 cm behind the posterior border of the frontal process of the zygomatic bone and 4 to 5 cm above the external auditory meatus. The hematoma was then evacuated with urokinase irrigation. Ultrasound guidance allows simple, precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.
Lee
Jung-Kil
JK
Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea. jklee0261@yahoo.com
Lee
Je-Hyuk
JH
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D020145:Basal Ganglia Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery*; D002404:Catheterization / Q000592:standards; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D012886:Skull / Q000033:anatomy & histology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator