Comparison of Surgical and Medical Treatment in Patients with Haemorrhagic Stroke
Keywords:
Haemorrhagic StrokeAbstract
Optimal management of spontaneous intracerebral haemorrhage (ICH) remains one of the highly debated areas in the fields of neurosurgery. Earlier studies comparing open surgical intervention with best medical management failed to show a clear benefit. More recent experience minimally invasive techniques have shown greater promise. We present our experience of 46 patients who presented to neurosurgery, neurology, Medical, Surgical and allied specialties at SIMS/ Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke and comparison as per outcome between Surgical and Medically treated patients. This is an ongoing study.
Objective: To compare the outcome results of surgical and medical management of the Haemorrhagic Stroke patients.
Study Design: A prospective ongoing study.
Place and Duration of Study: SIMS / Services Hospital, Lahore December 2013 until July 2015.
Materials and Methods: 46 patients who presented to neurosurgery, neurology Medical Surgical and allied specialties at SIMS/ Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke.
Results: 46 Adults patients meeting the inclusive criteria were included in our ongoing study, 26 patients in surgical group and 20 patients in medical group as already described in Pie Diagram 1. Out of 26 patients in surgical group 5 patients expired (19%) and 21 survived (81%).
Conclusion: Optimal cure of spontaneous intracerebral haemorrhage (ICH) is highly debatable neurosurgical problem. Past studies on comparison between surgical intervention with best medical management failed to show a clear improvement. However recent studies of minimally invasive techniques have shown greater promise5 . There is at present no clear indication for the surgical removal of ICH in the majority of the patients, but with deteriorating level of consciousness, many surgeons would agree surgical removal as a life saving procedure.
Abbreviations: AHA (American Heart Society), AVM (ArterioVenous Malformation), GCS (Glasgow Coma Scale), ICH (Intracerebral Hematoma), IVD (IntraVentricular Drainage), SAH (Subarachnoid Haemorrhage), HTN (Hypertension), DM (Diabetes Mellitus, STICH (supratentorial intracerebral haemorrhage).
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