Operative results of hypertensive intracerebral hematomas treated by stereotactic aspiration

Stereotactic aspiration for hypertensive intracerebral hematomas was performed in 23 patients, 10 cases of putaminal hemorrhage, 11 of thalamic hemorrhage, 1 of cerebellar hemorrhage, and 1 of hemorrhage in the caudate nucleus. Slight disturbance of consciousness was observed in 16 cases, and moderate or severe motor disturbance was noted in all cases. Intervals from the onset of disease to the operation ranged from 1 to 23 days (mean 7 days). Seventy-seven percent of the hematoma were aspirated (86 % for putaminal hemorrhage, 57 % for thalamic hemorrhage, 93 % for cerebellar hemorrhage, 100 % for hemorrhage in the caudate nucleus). Improvement of neurological deficits was seen within 1 week (mean 3.8 days) after operation in 17 patients, and good outcome (ADL I, II, III) was noted in 15 patients. There was postoperative improvement on CT scan in 8 of 23 cases, on SEP in 2 of 10 cases, on EEG in 1 of 1 case, and on 123I-IMP SPECT in 4 of 5 cases. Rebleeding occurred in only 1 patient, in whom hematoma was reaspirated successfully 7 days after the first operation. (author)