Stereotactic Evacuation on Intracereberall Hemorrhagie with Monitoring of Intracereberal Pressure.



Year of publication 2004
Type Article in Proceedings
Conference Proceedings - 3rd CENS Meeting
MU Faculty or unit

Faculty of Medicine

Field Neurology, neurosurgery, neurosciences
Keywords intracerebral haemorrhage; stereotactic evacuation; intracranial pressure
Description Based on our experience with stereotactic evacuation of spontaneous supratentorial hematomas we have used this method also for evacuation of spontaneous infratentorial hematoma by the transtentorial approach. We have also analysed dynamic changes of the intracranial pressure /ICP/ before and after stereotactic evacuation by the transtentorial approach with recording of the intraparenchymal ICP and pressure in hematoma. We have also analysed the amplitude and form of the ICP note. The authors present a series of 14 patients with spontaneous intracerebral hematomas evacuated by the frame-based stereotactic technique, in 6 patients we have measured intracranial pressure /ICP/ during stereotactic evacuation. We have used the frame-based stereotaxy with the Riechert Mundinger apparatus with the CT localisation of target and optimal trajectory. The intracranial pressure was measured by the intraparenchymal set made by the Codman company, in localisation: intraparenchymal before and after evacuation and in hematoma.We have also analysed the amplitude and form of each ICP note. Comparison of notes before and after stereotactic evacuation shows not only normalisation of the pressure values with amplitude reduction lower than border values 20 mm Hg, but also normalisation of the form of ICP curve . In general, after 30 days 67 % of the patients had better outcome and in 33 % the outcome was the same. The stereotactic evacuation of spontaneous infratentorial hematomas as a minimally invasive method reduces risk of complications related to craniotomy and also reduces strain of a patient, most interventions are performed in local anaesthesy. The measuring of the ICP and the analysis of dynamic changes during stereotactic evacuation suggest that this procedure can significantly reduce the ICP caused by ICH and we believe that our results can improve management of patients with spontaneous infratentorial intracerebral hematoma.
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