高血圧性脳出血に対する手術適応基準に関する検討:-軽症例について-

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There is no agreement of surgical treatment for mild cases of hypertensive intracerebral hematoma in which consciousness is not disturbed, or drowsy, and which are expected to survive. We reviewed the surgical results in 33 mild cases of intracerebral hematoma in the basal ganglia from the standpoint of morbidity. Surgery was undertaken 8-30 days after attack in 61%, and 2-5 months in 15%. There was no mortality after surgery. The site of hematoma was lateral type in all cases, complicated by intraventricular hemorrhage in 27%. The evacuated hematoma volume is less than 30ml in 33% of cases, 30-50ml in 48%, and 51-80ml in 18%. As to the improvement of hemiparesis by surgery, hemiparesis cleared up in 70% within one month and all cases recoverd well to normal condition within 3 months. As to the improvement of hemiplegia, complete recovery of finger movement was in 10%, partial recovery in 35%, no improvement in 55%. As to the improvement of legs, walk alone 35%, walk with stick in 60%, impossible to walk in 5%. The patients with hemiplegia could return to their work in 15%, take care of themselves in 55% and needed help in 25%, and needed nursing care in 5%. The recovery of finger movement was poor in the cases complicated by intraventicular hemorrhage.<BR>From the above results, recovery of hemiparesis might be promoted by evacuation of the intracerebral hematoma, even in the mild cases. The functional recovery of extremities is good, when surgery is undertaken within one month after attack, and also in the chronic cases (2 months after attack), symptomatic improvement can he anticipated by evacuation of intracerebral hematoma.
The Japanese Society on Surgery for Cerebral Strokeの論文

高血圧性脳出血に対する手術適応基準に関する検討:-軽症例について-

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