Delayed Stereotactic Computed Tomographic-Guided Aspiration in The Treatment of Intracerebral Hemorrhage:

• Main Authors: Chih-Ju Chang, 張志儒
• Other Authors: When-Ta Chiu M.D. Ph.D.
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/15366302203864464656

碩士 === 臺北醫學大學 === 醫學研究所 === 92 === Intracranial hemorrhage (ICH) is a very serious subtype of stroke. Spontaneous ICH has the highest mortality of all stroke subtypes, which 30-days mortality rate is 35% to 50%. Most survivors are typically left severely disabled, with significant personal, social and health service costs. So it is very important to find a correct treatment for the spontaneous ICH. Current treatment strategies are aimed toward reducing intracranial pressure to maintain adequate cerebral perfusion. The role of surgical treatment is still controversial, and there is no reliable information regarding the use of surgery for deep hematoma . With improvements in computerized tomography (CT), stereotaxic surgery has been applied in evacuation of the hematomas. The CT-guided stereotactic aspiration for intracerebral hemorrhage has following advantages: 1) the procedure is simple; 2) the operation can be performed under local anesthesia; and 3) the procedure can be applied in the thalamic hemorrhage. Many clinicians think the CT-guided stereotactic aspiration is an effective and safe treatment for intracerebral hemorrhage. CT-guided stereotactic aspiration of hematoma is usually combined with the use of thrombolytic agents, such as urokinase, tissue plasminogen activator (t-PA) to increase clearance ratio. However, use of thrombolytic agents may increase the risk of recurrent hemorrhage or/and expansion of hematoma. We describe our treatment protocol for the patients with spontaneous ICH by the delayed CT-guided stereotactic aspiration without thrombolytic agents and the preliminary experience about the clearance ratio, clinical outcome, and the radiological results. Our purpose was to assess the feasibility and effectiveness of this procedure and find a way to increase clearance ratio without increasing the risk of rebleeding. According to the result of our study, we believe delayed CT-guided stereotactic aspiration without thrombolytic agents is an effective and safe method to treat the spontaneous ICH.