A Comparative Analysis of Stereotactic Evacuation & Conservative Treatment in Hypertensive Putaminal Hemorrhage

Lee, Baek Heoyun; Huh, Sung Chul; Yoon, Kung Sik; Oh, Min Suk

Abstract

We have analysed 144 patients with hypertensive putaminal hemorrhage, admitting from January 1992 to December 1993. Surgical treated group with Komai's stereotactic system was 71 patients and medical treated group was 73 patients. The results were as follows: 1) The patients with ventricular rupture were 36 cases(25%). According to the degree of ventricular rupture, the mortality was increased and the good outcome was decreased(P<0.01). 2) The prognosis was evaluated in favorable condition(alert and drowsy) and unfavorable condition(stuporous, semicomatose, comatose). In unfavorable condition, the mortality of surgical patients was lower than that of non-surgical patients(P<0.01). 3) Surgical patients with smaller hematoma(< or = 40ml) showed btter outcome than non-surgical patients:The statistical difference was not significant. But in larger hematoma(>40ml), the outcome in both treated group was similar. 4) According to CT classification, in class II(extending to anterior limb of internal capsule), good outcome of surgical group was better than that of non-surgical group. In class V(extending th thalamus or subthalamus), the mortality in surgical group was lower than that of non-surgical group(P<0.05) .