고혈압성 찬막상부 뇌실질내출혈이 있는 혼수상태 환자에서 뇌정위적 혈종제거술 및 뇌실외배액술의 결과
Results of Stereotactic Evacuation of Hematoma and External Ventricular Drainage in Comatose Patients with Hypertensive Supratentorial Intracerebral Hemorrhage
소속 상세정보
홍성봉
유대진/송진규/양의중/장석정/신호
KMID : 0359819940230111244
Abstract
The purpose of this study was to analyze and evaluate therapeutic results of stereotactic evacuation of hematoma, urokinase irrigation and external ventricular drainage (EVD) in comatose patients who had hypertensive supratentorial intracerebral
hemorhage. The authors carried out stereotactic evacuation of hematoma and external ventricular drainage in the consecutive 45 cases who were admitted to the Department of Neurosurgery, Chosun University Hospital, from Sep. 1990 to Jun. 1993.
@ES The therapeutic result were as follows:
@EN 1) The peak age incidences were 6th to 7th decades. The incidence was higher in female than male. The age was not related to the prognosis.
2) The hematoma was located at the basal ganglia in 37 cases, and the thalamic area in 8 cases. The prognosis was poorer as the area of hematoma extended more wider and deeper
3) The volume of hematoma ranged from 8 to 155ml. The prognosis of the patient was unfavorable in large volume of hematoma.
4) Intraventricular hemorrhage (IVH) occured in forty cases (87.9%) and motality rate was 45%. The mortality rate was increased in cases with IVH than in cases without it.
5) The motality rates based on the Glasgow coma scale (GCS) on admission were 50% in GCS score 4 group, 50% in GCS score 5 group, 40% in GCS score 6 group, 27% in GCS score 7 group. Cases of low Glasgow coma scale on admission showed high
mortality
rate.
6) The overall motality rate was 42%.
These results suggest that stereotactic evacuation of hematoma and EVD decreased the mortality rate when compared with conservative treatment and conventional craniotomy in the literatures.
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