الفهرس | Only 14 pages are availabe for public view |
Abstract Intracerebral hemorrhage is the most devastating and disabling type of stroke. Uncontrolled hypertension is the most common cause of spontaneous ICH. A number of factors may affect outcome after ICH, including hematoma volume and location, hematoma expansion, age, GCS score on presentation, intraventricular extension and anticoagulant use. Recent advances in neuroimaging, organized stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant hypertension, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Our work aims to evaluate patients with spontaneous intracerebral hemorrhage underwent surgical evacuation This study was carried out in the unit of neurosurgery in Minia university hospital during the period of 2017. Each patient was evaluated by the surgical team as regard the patient complain, patient presentation, and history of any medical dieses or drug intake The study involved 20 patients. Each patient was investigated by brain CT in addition to other radiological investigation as MRI or cerebral angiography. All patients underwent surgical evacuation and postoperative CT to confirm proper evacuation of the hematoma. Complete recovery was achieved in 2 patients .7 patients recovered with neurological deficits as motor weakness and aphasia. Seven patients died and four became vegetative. Mean operation time was 135 (range 105-180) min with a mean postoperative stay of 9(range 7-21) days. Some complications occurred as residual hematoma, hydrocephalus, chest infection, pneumocephalus and postoperative seizures. Conclusion: In order to overcome the high mortality and morbidity, it is recommended that patients with spontaneous ICH should be admitted in well-organized specialized stroke care facilities with a multidisciplinary team approach. All the management principles including the close monitoring of vital signs and neurological status, rapid and adequate BP correction, proper ICP control and timely surgical management of selected patients, prevention of complications, and early rehabilitation are important for better clinical outcomes. |