[Intracerebral hematoma caused by rupture of intracranial angioma. Analysis, prognosis and clinical course of 35 comatose patients admitted to intensive care units].

The outcome of 35 patients in deep coma (GSS less than 7) due to an intracerebral hematoma following ruptured arteriovenous malformation (AVM) and admitted to a neurosurgical intensive care unit is reviewed. Eighty percent of these patients had a cerebral AVM and 20% had an AVM in the posterior fossa. All had a medical treatment of increase intracranial pressure (ICP). Twenty-four patients or 68.6% had an early surgical treatment or some days further and 13 had a good outcome, six had a persistent coma or a residual neurological deficit and five died. Four patients or 11.4% had an endovascular embolisation therapy and three had no satisfactory results and one died; all had a new intracranial hemorrhage with hematoma. Seven patients were not treated: four died before 48 hours of hospitalisation, one is in persistent coma and two are waiting an endovascular embolisation, alive but with a neurological deficit. The results suggest that neurosurgical treatment are a safe and effective means for treatment of these AVM with compressive intracranial hematoma.