Abstract
The aspiration of intracerebral hematoma (ICH) through burr hole is recently perfomed in stead of removing ICH by craniotomy. Stereotactic technique is usually used to aspirate hematoma. But authors simplified the operations by using free bands. Burr hole was made, orientating from CT finding, i. e., distance from Orbito-Meatal Line and midline of forehead. Hematoma was taped and aspirated. Irrigation or drainage of ICH was not performed.
These methods were carried out in three cases of putaminal hematoma and four cases of thalamic hematoma. The result of operation was excellent in all putaminal cases and good in only two cases of thalamic hematoma. Because primary damage of the brain was severe in the thalamic hemorrhage.
Our protocol of the treatment of ICH is described below. When ICH is larger than 6cm in diameter, craniotomy is immediately performed and hematoma is removed. When ICH is larger than 3cm and the patient exhibits hemiplegia, craniotomy is immediately performed. If the patient exhibits mild or moderate hemiparesis, conservative treatment is recommended. If the conservative therapy is continued more than one week and clinical signs are not improved, then aspiration of ICH is performed
