Evacuation of Spontaneous Thalamic and Intraventricular Hemorrhage under the Operating Microscope Improves Mortality Compared with External Ventricular Drainage——Mini-Cranioctomy for Thalamic and Ventricular Hemorrhage

Tomonori Tamaki,Akira Teramoto,Yoji Node

doi:10.4236/ojmn.2011.11001

Abstract

We performed direct hematoma evacuation of thalamic and intraventricular hemorrhage using mini-craniotomy in recent years. The present study evaluated the outcome and complications in 18 patients with spontaneous thalamic and intraventricular hemorrhage treated by mini-craniotomy hematoma evacuation with external ventricular drainage and 24 patients treated by only external ventricular drainage. Patients treated by mini-craniotomy were less likely to require days of ventricular drainage settlement, had a less suffering meningitis, had good hematoma evacuation rate and had a less mortality rate compared with those undergoing only external ventricular drainage. Frontal mini-craniotomy microscope operation is a simple and effective method for hematoma evacuation that causes fewer complications.

Highlights

When thalamic hemorrhage (Th Hx) is accompanied by severe intraventricular hemorrhage (IVH), the prognosis is poor [1,2,3,4,5]
The present study evaluated the outcome and complications in 18 patients with spontaneous thalamic and intraventricular hemorrhage treated by mini-craniotomy hematoma evacuation with external ventricular drainage and 24 patients treated by only external ventricular drainage
The present study evaluated the outcome, mortality rate and complications in eighteen patients with spontaneous Th Hx and IVH treated by frontal mini-craniotomy hematoma evacuation with external ventricular drainage (EVD) and twenty-four patients treated by only EVD

Summary

Introduction

When thalamic hemorrhage (Th Hx) is accompanied by severe intraventricular hemorrhage (IVH), the prognosis is poor [1,2,3,4,5]. Th Hx and IVH usually treated by external ventricular drainage (EVD) for obstructive hydrocephalus[1]. Several other opinions for Th Hx with IVH were reported to be CT-guided stereotactic hematoma aspiration, neuroendoscopic hematoma evacuation, and EVD with fibrinolysis [6,7,8,9]. For such severe cases, we performed direct hematoma evacuation by frontal mini-craniotomy transcortical approach in recent years [2]. The present study evaluated the outcome, mortality rate and complications in eighteen patients with spontaneous Th Hx and IVH treated by frontal mini-craniotomy hematoma evacuation with EVD and twenty-four patients treated by only EVD

Methods

Results

Conclusion