Intracranial Pressure Following Stereotactic Aspiration of Hypertensive Hematoma

Abstract

The authors encountered 16 cases of intracranial pressure (ICP) monitoring following a stereotactic evacuation of hypertensive hematomas. The patient's ages ranged form 45 to 85 years with 65.8 as the average. The site of hematoma was the putamen (8 cases), thalamus (6 cases), and cerebral subcortical (2 cases). All the patients were operated on within a few days form the onset. The hamatoma size ranged form 10.0 to 78.8ml, with the average of 35.5. The average rate of removal was 61.1%. Mean ICP for 3 days following the operation was kept below 15mmHg in 15 of the cases. This method appears effective for treating hypertensive intracranial hematoma in this aspect. One patient that showed high pressure over 15mmHg has suffered from an obstruction of the urinary tract due to bleeding of the bladder. This trouble was thought to be the cause. A group of patients with hematomas over 40ml before operation (Group A) showed a mean 12.5mmHg, this being statistically higher than that of group with hematomas below 40ml (Group B) that showed a mean 5.0. Cerebral perfusion pressure (CPP) of group A after an operation was 81.5mmHg, which was also statistically lower than that of group B. But there was no statistical significance between patients with hematomas over and below 10 ml after operation.