J Korean Neurosurg Soc.  1986 Jun;15(2):245-256.

Stereotaxic Evacuation of Brain Stem Hemorrhage

• Ko SK
• Chi YC
• Moon CB
• Choi BY
• Cho SH

Abstract

Usually cases of brain stem hemorrhage reveal high mortality and poor prognosis in spite of meticulous medical or surgical treatment. Recently we experienced stereotaxic evacuation of brain stem hemorrhage with Brown-Robert-Wells(B.R.W.) system in four cases. If there were residual hemorrhage after initial aspiration, those were evacuated with Urokinase irrigation via stereotaxically placed catheter in the hematoma. The entry point of our operation get on the crossing point of midpupillary line and 1cm behind coronal structure. Preliminary results : 1) Volume of removed hematoma : 5ml(average). 2) Dates of urokinase irrigation : 2 to 4 days after operation. 3) No hydrocephalus, no surgical mortality. 4) Average Glasgow coma scale was improved from 6 in preoperative state to 12 in postoperative state. 5) Operation was performed within 24 hours. 6) Advantages of our procedure. (1) Accurate, simple and safe. (2) Under local anesthesia. (3) Less traumatic procedure. (4) Could remove hematoma completely with Urokinase.

Keyword

Brain stem hemorrhage; Suboccipital craniectomy; Stereotaxic aspiration; Cryptic vascular malformation; Urokinase; Brown-Roberts-Wells system

MeSH Terms

Anesthesia, Local
Brain Stem*
Brain*
Catheters
Glasgow Coma Scale
Hematoma
Hemorrhage*
Hydrocephalus
Mortality
Prognosis
Urokinase-Type Plasminogen Activator
Urokinase-Type Plasminogen Activator