The aspiration therapy of putaminal hemorrage in subacute phase
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概要
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Recently aspiration therapy for intracerebral hematoma through a burr hole has been reported with good result. Althrough in many literatures stereotactic devices are used to determine the location of the tip of the needle, we report the simplified method of CT guided manual insertion of the needle.<BR>The location of a burr hole is settled on the CT film by two mesurements, ie distance from orbito-meatal line and the midline of forehead to hematoma.<BR>This technique would shorten operation time and be available even for the aged of high risk. Operative timing should be set in the subacute stage when hematoma becomes liquefied without danger of rebleeding by aspiration.<BR>This method had been applied in ten cases of putaminal haemorrage. Four cases improved disturbance of consciousness and another four cases gradually recovered hemiparesis in a week after the operation.<BR>Our protocal for treatment of putaminal haemorrage is as in the followings. If hematoma is larger than 6 cm in the largest diameter and pupils are not fully dilated, removal of hematoma by craniotomy is immidiately performed. If hematoma is larger than 3 cm and a patient exhibits hemiplegia, craniotomy is also planned. If moter deficid is mild or moderate, conservative treatment is recommended. When neurological signs do not improve after more than one week of conservative treatment, aspiration of hematoma is a choice of treatment.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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