¨Ï The Journal of Cerebrovascular and Endovascular Neurosurgery
Optimal Surgical Timing of Aspiration for Spontaneous Supratentorial Intracerebral Hemorrhage
Sooji Sirh, Hye Ran Park
Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
Objective : Minimally invasive techniques such as stereotactic aspiration
have been regarded as promising alternative methods to replace craniotomy
in the treatment of intracerebral hemorrhage (ICH). The aim of this
study was to identify the optimal timing of stereotactic aspiration and analyze
the factors affecting the clinical outcome.
Materials and Methods : This retrospective study included 81 patients
who underwent stereotactic aspiration for spontaneous supratentorial ICH
at single institution. Volume of hematoma was calculated based on computed
tomography scan at admission, just before aspiration, immediately
after aspiration, and after continuous drainage. The neurologic outcome
was compared with Glasgow outcome scale (GOS) score.
Results : The mean volume ratio of residual hematoma was 59.5% and
17.6% immediately after aspiration and after continuous drainage for an
average of 2.3 days, respectively. Delayed aspiration group showed significantly
lower residual volume ratio immediately after aspiration.
However, there was no significant difference in the residual volume ratio
after continuous drainage. The favorable outcome of 1-month GOS 4 or
5 was significantly better in the group with delayed aspiration after more
than 7 days (p = 0.029), despite no significant difference in postoperative
6-months GOS score. A factor which has significant correlation with postoperative
6-months favorable outcome was the final hematoma volume
ratio after drainage (p = 0.028).
Conclusion : There is no difference in final residual volume of hematoma
or 6-months neurologic outcome according to the surgical timing of hematoma
aspiration. The only factor affecting the postoperative 6-months
neurologic outcome is the final volume of remaining hematoma after drainage.
Editorial Office Contact Information
The Journal of Cerebrovascular and Endovascular Neurosurgery (JCEN), Department of Neurosurgery, The Catholic University of Korea, Bucheon St. Mary's Hospital 327, Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, Korea 420-717
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