| The Benefits of Early Stereotactic Evacuation for Spontaneous Supratentorial Intracerebral Hemorrhage in Elderly Patients (Over 65 Years) |
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Ju-Sung Seo , Sang-Soak Ahn , Hyung-Dong Kim |
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Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea |
| 65세 이상 고령의 천막상부 자발성 뇌실질내 출혈 환자에서 조기 정위적 혈종 제거술의 우수성 |
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서주성ㆍ안상석ㆍ김형동 |
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동아대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
Spontaneous supratentorial intracerebral hemorrhage (ICH) can be considered as one of the most common forms of cerebrovascular disease. The purpose of this study is to evaluate benefits of early stereotactic surgery for spontaneous supratentorial hypertensive ICH in elderly patients.
Methods
We retrospectively reviewed the medical records of spontaneous supratentorial hypertensive ICH patients aged 65 years or older, who were treated surgically in our institution between January 2006 and December 2010. Fifty-six patients with elderly and spontaneous supratentorial ICH were underwent stereotactic hematoma evacuation. Patients were divided into early surgery group (within 24 hours from bleeding, Group I) and late surgery group (after 24 hours from bleeding, Group II).
Results
Early surgery within 24 hours significantly reduced the incidence of pneumonia, compared to late surgery (Mann-Whitney U test, p<0.05). When Glasgow Outcome Scale (GOS) score was evaluated at the time of discharge, there was a trend of acquiring much better GOS score (GOS≥4) when surgery timing was early (p=0.007 in Univariate analysis, p=0.042 in Multivariate analysis).
Conclusion
Early stereotactic evacuation of spontaneous supratentorial ICH facilitates better patient's management in elderly patients. Medical complication, especially pneumonia was associated with a mortality and poor outcome. In elderly ICH patients, early stereotactic evacuation should be considered more actively. |
| Key Words:
Elderly patientㆍPneumoniaㆍIntracerebral hemorrhageㆍStereotactic aspiration |
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