Effects and complications of stereotactic aspiration for spontaneous intracerebral hemorrhage.
Stereotactic aspiration of intracerebral hemorrhage (ICH) improves the general condition of patients, promotes improvement of consciousness, and decreases the incidence of pneumonia, but may induce rebleeding. The present study investigated the effects of stereotactic aspiration and factors that inhibit rebleeding in 70 consecutive patients who underwent stereotactic aspiration for ICH. Consciousness was significantly improved after surgery. Of patients who underwent surgery on day 0 or 1, 5 patients developed pneumonia and 29 patients did not. Of patients who underwent surgery on day 2 or later, 14 patients developed pneumonia and 22 patients did not. Early surgery within 2 days significantly reduced the rate of aspiration pneumonia. Patients with rebleeding tended to have liver dysfunction and hemorrhagic tendency. Early stereotactic aspiration of ICH facilitates better patient management than conservative treatment in patients with moderate consciousness disturbance. Patients with liver dysfunction and hemorrhagic tendency should be identified.
Umebayashi
Daisuke
D
Department of Neurosurgery, Kyoto Second Red Cross Hospital, Kamanza-Marutamachi, Kamigyo-ku, Kyoto, Japan.
Mandai
Ayako
A
Osaka
Yasuhiko
Y
Nakahara
Yoshikazu
Y
Tenjin
Hiroshi
H
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000401:mortality / Q000601:surgery*; D015600:Glasgow Coma Scale; D006801:Humans; D007564:Japan; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011015:Pneumonia, Aspiration / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013238:Stereotaxic Techniques; D013396:Suction / Q000009:adverse effects* / Q000379:methods*; D016019:Survival Analysis; D014207:Trephining / Q000009:adverse effects / Q000379:methods*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors