軽症例の保存的及び外科的治療の限界について:-特にCTを中心に-

概要

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We experienced 52 patients with hypertensive intracerebral hemorrhage during last 15 months. We analized the sites of hemorrhage in all patients based on CT and classified the putaminal and thalamic hemorrhage into each 3 types. <BR>We have used the classification to decide the surgical indication and to suppose the prognosis of hypertensive intracerebral hemorrhage. <BR>In the group of putaminal hemorrhage, small hematomas showing under 3cm diameter high density (type 1) have been treated by non surgical procedure and surgical treatment have done the moderate or large hematomas showing over 3cm diameter high density (type 2 and type 3). Clinical evaluation showed good results except cases of hematoma extending into the thalamus with destruction of the internal capsule and/or a large high density in the ventricles (type 3). <BR>On the other hand, in super-acute stage even a little hemorrhage often develops a large hematoma gradually and so it is necessary to perform following CT scan. <BR>The group of thalamic hemorrhage have usually been treated by non surgical procedure. In the cases of good clinical evaluation, hematomas show superior and lateral extention and often perforating into the ventricles slightly. We consider that ventricle drainage for these cases are useful.
The Japanese Society on Surgery for Cerebral Strokeの論文