抄録
Timing of operation in patients with hypertensive intracerebral hematoma was investigated from the surgical results in 51 patients operated on within 3 days after the attack. The highest over-all mortality was noted in patients who had been operated on within 24 hours. The patients with semicoma, grade III and IV in our neurological classification, showed the worst results in this group.
The patients with somnolence or stupor, grade I or II in our neurological classification, showed lower mortality in comparison with the patients in grade III and IV. No relationship between the timing of operation and operative death was confirmed in patients with somnolence or stupor. It was noted, however, that the patients who had been operated on comparatively soon after the attack showed better results in activities of daily living (ADL) at 6 months after surgery.
Out of 24 patients in grade III or IV, 15 survived at one month after surgery, and the results were evidently better in comparison with non-surgical cases reported by other authors. Eleven out of 15 surviving patients became clear in consciousness after surgery, and the interval of unconsciousness after surgery increased in proportion to the length of time from attack to operation. Although further studies are required, some patients in grade III and IV showed good recovery in ADL at 6 months after surgery. As a conculusion, our results suggested that even in severe cases, surgical treatment should be considered as soon as posible after the attack.
