Clinical Analysis of Stereotactic Aspiration and Conservative Management in Spontaneous Thalamic Hematoma.
- Author:
Cheon Hyun NAM
1
;
Jae Kyu KANG
;
Jong Oung DOH
;
Chun Dae LEE
Author Information
1. Department of Neurosurgery, National Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Thalamic hemorrhage;
Stereotactic aspiration;
Conservative medical therapy;
Urokinase irrigation
- MeSH:
Craniotomy;
Hematoma*;
Hemorrhage;
Humans;
Internal Capsule
- From:Journal of Korean Neurosurgical Society
2001;30(2):156-162
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. METHODS: The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows: age and sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. RESULTS: The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows: good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age and sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. CONCLUSION: Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
