Raihan M Z, Rashid M H, Syed M A, Sarkar M H
Department of Neurosurgery, Dhaka Medical College, Dhaka, Bangladesh.
Mymensingh Med J. 2009 Jul;18(2):245-9.
The study was done for determination of the potential factors of good outcome in spontaneous intracerebral haematoma (SIH) which could be useful for selecting patients for surgical procedure. Subjects were 45 patients with spontaneous intracerebral haematoma (SIH)-Volume >20ml. They were admitted and surgically treated consecutively in Dhaka Medical College with in the 1st day to 4th day of ictus. Haematoma volume was measured on computed tomography (CT) at admission. Good outcome was measured by Glasgow Outcome Scale (GCS) score. Out of 45 patients with ICH, 18(40%) patients had basal ganglia haematoma, 13(28.88%) patients had lobar haematoma, and 2(4.45%) patients had cerebellar haematoma and 7(15.55%) patients had pure ventricular haematoma and 5(11.12%) patients ventricular extension from other location. Among these last 12 patients, 10(83.33%) patients died comparing only 7(21.21%) patients without ventricular involvement died. Fisher's exact test result shows p value is <0.001(Highly significant) and best outcome obtained in cases of lober haematoma in CT scan of brain, the mean volume was 46 cc. and there was strong association between the volume of haematoma and Glasgow outcome scale, that is, more the volume of blood, less the Glasgow Outcome Scale (GOS) and vice versa. P value was <0.001 (Highly significant). In another study the surgical outcome is best if it is done within 48 hours. Fisher's exact test result shows p value is <0.05. So, Good surgical outcome in spontaneous intracerebral haematoma (SICH) can be predicted on admission by volume of haematoma, location of haematoma, time lapse since ictus to surgery. These predictors may be helpful in selecting patients for surgical treatment.
