Abstract

Surgical evacuation of intrcerebral hematomas is one of the known method of management of intracerebral haemorrhage. Decompressive craniectomy is one of the surgical procedures used of management of intracerebral haemorrhage. Present study was aimed to analysed the role of surgical management in the management of basal ganglia hematoma. Material and Methods: Present study was prospective, observational study, conducted in patients with spontaneous basal ganglia hematoma underwent surgical management either craniotomy and evacuation of hematoma or by decompressive craniectomy and evacuation of hematoma under general anaesthesia. Results: Among 50 patients majority were form 41-60 years age group (50 %), were male (54 5), left side affected (62 %), had history of hypertension (74 %) & diabetes mellites (44 %). Hematoma volume was 61- 90 ml (46 %) in majority cases followed by >90 ml (30 %) & ≤ 60 ml (24 %). Midline shift of 1.1 cm noted in 18 % patients, 1.2 cm noted in 26 % patients & 1.3 cm noted in 20 % patients. Other findings were intraventricular Hemorrhage (62 %) & hydrocephalus (8 %). No post-operative hematoma noted in 46 % cases, while in other 46 % cases hematoma was < 30 ml. In majority of cases duration of surgery was 3- 3. 5 hours (50 %) & blood loss was 151-200 ml (30 %). 30 patients (60 %) required 2 procedures.. At 6 months mortality was noted among 20 patients (40 %). GCS score & GOS score improvement was noted at 6 months follow-up as compared to GCS at discharge, at 1 week & at 1 month. Conclusion: Prognosis and mortality associated with surgical management of spontaneous basal ganglia hematomas are affected by patient age, hematoma location and volume, intraventricular hemorrhage, and patient’s initial neurologic status

Description

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