Abstract
Relationship between the volume of putaminal hemorrhage in acute stage and ipsilateral CBF in chronic stage was investigated on surgical group (14 cases) and conservative group (16 cases). The volume of hematoma was calculated by the high density area demonstrated on brain CT scan within 24 hours after the onset. CBF was measured 1 to 6 months after the onset with 133Xe inhalation method expresseing by initial slope index.
The volume of hematoma ranged 15 to 84 ml in surgical group, and 5 to 50 ml in conservative group. In conservative group. negative correlation between the volume of hematoma in acute stage and CBF in chronic stage was significant (r=-0.60, p<0.05), but there was no correlation in surgical group (r=-0.36). In the hematoma of 15 to 50 ml, mean values of CBF in the surgical group (11 cases, 36.4 ± 7.1 ml/100 g/min) did not significantly differ from that in the conservative group (11 cases, 37.8 ± 8.1 ml/100 g/min). In 3 operated-patients with hematoma over 50 ml, however, CBF (30.9 ± 5.2 ml/100 g/min) preserved beyond expectation from negative correlation in conservative group. Furthermore there were no differences in ADL and intellectual performance between surgical group and conservative group.
It was suggested that surgical treatment was not superior to conservative treatment for cerebral blood flow and for ADL in putaminal hemorrhage less than 50 ml, but might be superior in the hematoma more than 50 ml.
