基底核部出血軽症例の手術適応基準:-その病態生理からの検討-

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For indication of clot evacuation for the mild cases with basal ganglionic hemorrhage, findings of computed tomography (CT), cerebral angiography (CAG), intracranial pressure (ICP) and cerebral blood flow (CBF) dynamics surrounding tissues of intracerebral hematoma were analysed in detail. The cases with localized hematoma in putaminal region, whose consciousness is almost alert within 24 hours of onset, have full recovery by conservative treatment. The cases of advanced type, in which the location of hematoma is in coronal radiation and putaminal region in the dominant sided hemispheres, should be operated sometimes. The postoperative results are in full recovery or minimal redisual disability. Their consciousness within 24 hours of onset is somnolent. For the cases, whose lesions are localized in coronal radiation, internal capsule, thalamus, subthalamic region, putamen, globus pallidum and so forth, the clot evacuation should be certainly performed. The level of consciousness within 24 hours of onset is somnolent or stuporous. The postoperative results are in minimal or moderate redisual disability. The timing of operation is suitable within 1 day of onset before recognizing luxury perfusion syndrome in CAG. However, if possible, it is more desirable that the clot evacuation should be performed within 6 hours after onset before appearance of perifocal low density areas and/or abnormal CBF dynamicsa around intracerebral hematoma.
The Japanese Society on Surgery for Cerebral Strokeの論文

基底核部出血軽症例の手術適応基準:-その病態生理からの検討-

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