Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

Abstract

The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS). The surgical treatment was successful in 14 patients (37%), whereas it was unsuccessful in 24 patients (63%). We have detected a significant negative correlation between the Glasgow Coma Scale (GCS) scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.

Profile of Clinical and Radiological Factors of Intracerebral Hemorrhage Stroke Patients in Dr. Soetomo Hospital

“…The older the patient the higher the death rate. This is in line with the study of Rendevski et al, Independently, age affects the outcome of patients significantly at a young age with a higher percentage of life 6 . This is because in young adult patients the entire physiology of the body is still running well and the regeneration power is still high.…”

“…GCS variables were divided into three categories, namely the conscious category (> 13), unconscious (5)(6)(7)(8)(9)(10)(11)(12)(13) and unconscious (<5). It can be seen that the percentage of GCS respondents in the conscious category (0-4) is 28.3% with a frequency of 70 respondents.…”

“…Based on the STICH research data, it can be concluded that operative measures provide benefits for ICH with Infratentorial locations. But for the Supratentorial location, there is still debate and controversy for handling operatives 6 . Here the author wants to try to examine more specifically which subgroups benefit from operative Treatments by comparing clinical factors, namely the level of consciousness (Glasgow Coma Scale) and age 7 .…”