被殼出血重症例の手術適応:-高齢とExtravasation-

概要

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Twenty patients with severe hypertensive putaminal hemorrhage were assessed for clinical analysis and surgical results. There were 16 deaths of whom were 4 in coma, 6 in come with extravasation, 2 in semi-coma with extravasation, 3 in semicome with over 65 years of age and 1 in stupor with extravasation on preoperative state and angiography. There were 4 survivors all of whom remain in a state of akinetic mutism were over 65 years of age. Leakage of contrast medium on angiography was shown in 57 per cent of patients within 6 hours after stroke but rare after 9 hours of apoplectic onset. To our limited experience early surgical intervention within six hours of apoplectic onset seems to be imperative prior to irreversible damage to deep vital structures. However, operative treatment is advisable to be reserved for those who, showing extravasation on angiography are older than 65 years of age or in a poor general condition.