Stereotactic evacuation of spontaneous intracerebral hematomas

THESES

STEREOTACTIC EVACUATION OF SPONTANEOUS INTRACEREBRAL HEMATOMAS (ABSTRACT)^*. THESIS. RIO DE JANEIRO, 1998.

CESAR FANTEZIA ANDRAUS ^**

Spontaneous intracerebral hematomas (SIH) occur in 15/100 000 people per year. Despite the better control of hypertensive diseases, SIH is responsible for 10% of strokes. Until this moment, there is no treatment of comproved efficacy for SHI. The decision on removing or not a deep hematoma for opened craniotomy or stereotactic evacuation remains controversial. However, the high mortality (43% in 30 days) associated to non surgical treatment suggested the necessity of precocious and innovated techniques, for better results.

The objectives are to review the literature, evaluating the results of large series and to purpose the application of the stereotactic evacuation in our centre.

This study summed up many articles, that have been published since 1972, on stereotactic evacuation of SIH. It tried to emphasize the importance of computed tomography guided stereotactic evacuation of SHI to treat a disease of high rates of morbidity and mortality, studying in large series the indications and characteristics of the SIH that make them candidates for stereotactic evacuation.

Stereotactic evacuation of SHI is an easy, minimal invasive technique, particularly indicated in deeply localized hematomas. The risk of bleeding after evacuation is low (<2.5%), and its occurrence can be detected and controlled during the procedure. The duration time for this technique is smaller than for conventional surgery, and it can be accomplished in severely compromised patients, under local anesthesia and sedation. Clinical and experimental trials showed progressively better results with this technique.

KEY WORDS: intracerebral hematoma, stereotactic neurosurgery, arterial hypertension.

** Address: Rua Djalma Ulrich 201 / 1201, 22071-020 Rio de Janeiro, Brasil.

*

Drenagem estereotáctica de hematomas intracerebrais espontâneos (Resumo). Tese de Mestrado, Universidade Federal do Rio de Janeiro (Área: Cirurgia Geral/Neurocirurgia). Orientador: Flávio Freinkel Rodrigues.

Publication Dates

• Publication in this collection
  06 Dec 2000
• Date of issue
  Sept 2000