Stereotactic Aspiration of 37 Cases of Hypertensive Intracranial Hemorrhage and Attendant Problems

The authors treated 37 cases of hypertensive intracranial hemorrhage by stereotactic aspiration. Problems encountered in the therapy are discussed. Patient age ranged form 45 to 85 years old, with a mean of 66.0. Eighteen of the patients were male and 19, female. Hematoma sites were putamen (19 cases) , thalamus (11 cases) , or subcortex (7 cases). Hematoma volume ranged from 10.0 to 90.4ml, with the average of 34.0ml. We removed 77.7% of the hematomas on the average, and no severe complications could be detected. One of the difficult problems in the manual aspiration was to remove hematomas which consisted of hard clots and liquid component. The liquid component was aspirated to some extent by repeating injection of saline and aspiration. If once hard clots obstruct the aspiration tip, we could not reduce the hematoma size except for reinsertion of the tip. In such cases smaller injector was more useful than bigger one because the latter aspirates hard clots so fast that the tip was easily obstructed. The other problem was thalamic hematoma perforating the ventricles as well as rebleeding. Fortunately we managed to control rebleeding by injection of thrombin powder. But as to thalamic hematoma it was difficult to reduce the size once the liquor started to be aspirated.

高血圧性脳出血

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