J Korean Neurosurg Soc.  2017 Sep;60(5):591-596. 10.3340/jkns.2016.0809.002.

Significant Risk Factors for Postoperative Enlargement of Basal Ganglia Hematoma after Frameless Stereotactic Aspiration: Antiplatelet Medication and Concomitant IVH

• Son W
• Park J

• KMID: 2457967
• DOI: http://doi.org/10.3340/jkns.2016.0809.002

Abstract

OBJECTIVE
Frameless stereotactic aspiration of a hematoma can be the one of the treatment options for spontaneous intracerebral hemorrhage in the basal ganglia. Postoperative hematoma enlargement, however, can be a serious complication of intracranial surgery that frequently results in severe neurological deficit and even death. Therefore, it is important to identify the risk factors of postoperative hematoma growth.
METHODS
During a 13-year period, 101 patients underwent minimally invasive frameless stereotactic aspiration for basal ganglia hematoma. Patients were classified into two groups according to whether or not they had postoperative hematoma enlargement in a computed tomography scan. Baseline demographic data and several risk factors, such as hypertension, preoperative hematoma growth, antiplatelet medication, presence of concomitant intraventricular hemorrhage (IVH), were analysed via a univariate statistical study.
RESULTS
Nine of 101 patients (8.9%) showed hematoma enlargement after frameless stereotactic aspiration. Among the various risk factors, concomitant IVH and antiplatelet medication were found to be significantly associated with postoperative enlargement of hematomas.
CONCLUSION
In conclusion, our study revealed that aspirin use and concomitant IVH are factors associated with hematoma enlargement subsequent to frameless stereotactic aspiration for basal ganglia hematoma.

Keyword

Stereotactic techniques; Suction; Basal ganglia hemorrhage; Risk factors

MeSH Terms

Aspirin
Basal Ganglia Hemorrhage
Basal Ganglia*
Cerebral Hemorrhage
Hematoma*
Hemorrhage
Humans
Hypertension
Risk Factors*
Statistics as Topic
Stereotaxic Techniques
Suction
Aspirin

Figure

• 

  Fig. 1 Brain CT scan of patient with postoperative hematoma enlargement. Preoperative CT (A) shows basal ganglia hemorrhage with concomitant intraventricular hemorrhage. Follow-up CT 12-hours after operation (B) shows hematoma enlargement in basal ganglia in spite of stereotactic aspiration. CT: computed tomography.

Reference

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