Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma

Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Eshra, Mohamed A. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Intracerebral hematoma Stereotactic evacuation Tubular evacuation

Anmerkung:	© The Author(s) 2018

Übergeordnetes Werk:	Enthalten in: Egyptian journal of neurosurgery - Berlin : Springer, 2014, 33(2018), 1 vom: 31. Aug.
Übergeordnetes Werk:	volume:33 ; year:2018 ; number:1 ; day:31 ; month:08

Links:	Volltext

DOI / URN:	10.1186/s41984-018-0016-5

Katalog-ID:	SPR038368706

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520			\|a Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable.
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allfields	10.1186/s41984-018-0016-5 doi (DE-627)SPR038368706 (SPR)s41984-018-0016-5-e DE-627 ger DE-627 rakwb eng Eshra, Mohamed A. verfasserin (orcid)0000-0003-1730-7626 aut Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2018 Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213 Enthalten in Egyptian journal of neurosurgery Berlin : Springer, 2014 33(2018), 1 vom: 31. Aug. (DE-627)1024903680 (DE-600)2933751-3 2520-8225 nnns volume:33 year:2018 number:1 day:31 month:08 https://dx.doi.org/10.1186/s41984-018-0016-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 33 2018 1 31 08
spelling	10.1186/s41984-018-0016-5 doi (DE-627)SPR038368706 (SPR)s41984-018-0016-5-e DE-627 ger DE-627 rakwb eng Eshra, Mohamed A. verfasserin (orcid)0000-0003-1730-7626 aut Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2018 Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213 Enthalten in Egyptian journal of neurosurgery Berlin : Springer, 2014 33(2018), 1 vom: 31. Aug. (DE-627)1024903680 (DE-600)2933751-3 2520-8225 nnns volume:33 year:2018 number:1 day:31 month:08 https://dx.doi.org/10.1186/s41984-018-0016-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 33 2018 1 31 08
allfields_unstemmed	10.1186/s41984-018-0016-5 doi (DE-627)SPR038368706 (SPR)s41984-018-0016-5-e DE-627 ger DE-627 rakwb eng Eshra, Mohamed A. verfasserin (orcid)0000-0003-1730-7626 aut Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2018 Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213 Enthalten in Egyptian journal of neurosurgery Berlin : Springer, 2014 33(2018), 1 vom: 31. Aug. (DE-627)1024903680 (DE-600)2933751-3 2520-8225 nnns volume:33 year:2018 number:1 day:31 month:08 https://dx.doi.org/10.1186/s41984-018-0016-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 33 2018 1 31 08
allfieldsGer	10.1186/s41984-018-0016-5 doi (DE-627)SPR038368706 (SPR)s41984-018-0016-5-e DE-627 ger DE-627 rakwb eng Eshra, Mohamed A. verfasserin (orcid)0000-0003-1730-7626 aut Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2018 Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213 Enthalten in Egyptian journal of neurosurgery Berlin : Springer, 2014 33(2018), 1 vom: 31. Aug. (DE-627)1024903680 (DE-600)2933751-3 2520-8225 nnns volume:33 year:2018 number:1 day:31 month:08 https://dx.doi.org/10.1186/s41984-018-0016-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 33 2018 1 31 08
allfieldsSound	10.1186/s41984-018-0016-5 doi (DE-627)SPR038368706 (SPR)s41984-018-0016-5-e DE-627 ger DE-627 rakwb eng Eshra, Mohamed A. verfasserin (orcid)0000-0003-1730-7626 aut Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2018 Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213 Enthalten in Egyptian journal of neurosurgery Berlin : Springer, 2014 33(2018), 1 vom: 31. Aug. (DE-627)1024903680 (DE-600)2933751-3 2520-8225 nnns volume:33 year:2018 number:1 day:31 month:08 https://dx.doi.org/10.1186/s41984-018-0016-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 33 2018 1 31 08
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Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. 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author	Eshra, Mohamed A.
spellingShingle	Eshra, Mohamed A. misc Intracerebral hematoma misc Stereotactic evacuation misc Tubular evacuation Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
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topic_title	Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma Intracerebral hematoma (dpeaa)DE-He213 Stereotactic evacuation (dpeaa)DE-He213 Tubular evacuation (dpeaa)DE-He213
topic	misc Intracerebral hematoma misc Stereotactic evacuation misc Tubular evacuation
topic_unstemmed	misc Intracerebral hematoma misc Stereotactic evacuation misc Tubular evacuation
topic_browse	misc Intracerebral hematoma misc Stereotactic evacuation misc Tubular evacuation
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title	Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
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title_full	Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
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title_sort	tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
title_auth	Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
abstract	Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. © The Author(s) 2018
abstractGer	Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. © The Author(s) 2018
abstract_unstemmed	Objective Primary intracerebral hemorrhage due to hypertension or amyloid angiopathy is a major catastrophe to the brain especially in old age. It forms 20–30% of all strokes. Open craniotomy for evacuation of the hematoma may not be applicable in some patients with uncontrolled blood pressure and bad general conditions that do not permit general anesthesia. This study investigated the safety and efficacy of two minimally invasive procedures in the evacuation of spontaneous hypertensive medium to large intracerebral hematomas. Patients and methods This is a retrospective study during the period from June 2008 to December 2016; 36 patients suffering from hypertensive intracerebral hematoma were investigated, operated upon, and followed up for at least 1 year. The hematomas were evacuated by CT-guided stereotactic procedures in 18 patients and by microscopic assisted tubular approach in the other 18 patients. The age of patients ranged from 48 to 79 years. There were 26 males and 10 females included in the study. GCS on presentation was 8–13. Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. This makes rehabilitation easier and further deterioration avoidable. © The Author(s) 2018
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title_short	Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma
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Results In patients of the tubular group (15 males + 3females), the total mortality was 4 patients and 14 patients experienced different degrees of improvement: 3 patients were conscious with no deficits and good recovery, 9 patients were conscious with mild disability, and 2 patients were conscious with severe disability. The final results in patients (11 males + 7 females) managed by stereotactic resection and thrombolysis of the hematoma after the follow-up period were as follows: 5 patients died, 1 patient was conscious with severe disability, 10 patients were conscious with mild disability, and 2 patients were conscious with complete recovery. Conclusions Minimally invasive hematoma resection procedures have advantages of reducing time and amount of surgical stress, the possibility of doing them under local anesthesia, facility of earlier evacuation, and reduced tissue trauma. Performing the procedures under image monitoring may be helpful in anticipating and detecting intraoperative accidents. Stereotactic aspiration is still helpful in chronic stage, where the clot becomes liquefied and easy for simple aspiration. 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Tubular versus stereotactic evacuation of medium- to large-sized supratentorial spontaneous intra cerebral hematoma

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