大脳基底核部高血圧性脳内出血:-その手術時期と転帰-

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The authors defined 4 grades in an acute phase of hypertensive intracerebral homorrhage in basal ganglial area. Surgery should be performed to the grade II in a functional view point and also to the grade III in a view point of survival rate. We reported the relationship between the time of surgery and its outcome in each of the grade II and the grade III. In the grade II (state of consciousness: somnolence-stuper, motor system: moderate paresis-paralysis), the functional outcome of surgical group was superior to that of non surgical group. In the surgical group, cases who were operated until 72 hours after onset were different from the cases who were operated after 72 hours in a view point of rapidity of recovery of consciousness. The cases in grade II with a severely complicated disease, because of which they could not endure the anesthesia, surgery should not be carried on, for non surgical group also had good results in survival rate.<BR>In the grade III (state of consciousness: semicoma-coma, motor system: moderate paresis-decerebrate rigidity), both functional and survival outcome of surgical group were superior to those of non non surgical group. In the surgical group, it took 11.6 days in the mean for the patients who were operated until 72 hours after onset to recover to the almost clear consciousness. And it took 19.6 days in the mean for those who were operated after 72 hours from onset to recover to the state of almost clear consciousness.<BR>So surgery should be performed to the grade III until 72 hours after onset, and it was better that the operation was performed as soon as possible during 72 hours.

大脳基底核部高血圧性脳内出血:-その手術時期と転帰-

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