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Barde N, VV R C, Kulkarni D, Chawada M. A Comparative Study on Therapeutic Modalities of
Spontaneous Supratentorial Intracerebral Hemorrhage
at a Teaching Institute. Iran J Neurosurg 2025; 11 : 2
URL: http://irjns.org/article-1-383-en.html
URL: http://irjns.org/article-1-383-en.html
1- Department of Neurosurgery, Vilasrao Deshmukh Government Medical College, Latur Superspeciality Hospital, Latur, India.
2- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, India.
3- Department of Neurosurgery, Vilasrao Deshmukh Government Medical College, Latur Superspeciality Hospital, Latur, India. ,devdk.kulkarni@gmail.com
2- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, India.
3- Department of Neurosurgery, Vilasrao Deshmukh Government Medical College, Latur Superspeciality Hospital, Latur, India. ,
Abstract: (378 Views)
Background and Aim: To evaluate immediate outcomes and prognostic factors in surgical and medical treatment for spontaneous supratentorial intracerebral hemorrhage (SICH).
Methods and Materials/Patients: We prospectively investigated the two treatment groups, medical (88 patients) and surgical (40 patients), based on standard guidelines between May 2018 and November 2019. Immediate outcomes in the two groups were measured using the Glasgow outcome scale (GOS) at three months. Prognostic factors in the two groups were compared using the chi-square test.
Results: Of 128 patients with spontaneous SICH, 88 were in the medical group, and 40 were in the surgical group. The mean age of the medical group was 57±13 years, and that of the surgical group was 53.7±12 years. In both groups, the predominant bleeding site was the left capsuloganglionic region.
Hypertension was the most common risk factor in both groups (90%). In the medical group (n=88), 57 patients (65%) had good outcomes, and 31 patients (35%) had poor outcomes. In the surgical group (n=40), 19 patients (48%) had good outcomes, and 21 patients (35%) had poor outcomes. Mortality rates were 25% (n=22) in the medical group and 30% (n=12) in the surgical group till 3 months. Patients in our surgical group with intracerebral hemorrhage (ICH) score of 3 had a poorer outcome (68%) and lower mortality (46%) than those in the medical group (66% poor outcome and 55% mortality). The medical group with intraventricular hemorrhage (IVH) (n=28) had poor and good outcomes in 71% and 29% of cases, respectively. The surgical group with IVH (n=20) had poor outcomes in 85% of cases and good outcomes in 15% of cases. The medical and surgical groups without IVH had similar good outcomes in 80% of the cases.
Conclusion: The surgical group had improved outcomes compared to the medical group containing patients with midline shift >6 mm, >30 cc of bleed, and Glasgow coma scale (GCS) 8-12. With higher ICH scores and IVH, the surgical group showed poorer outcomes and fewer deaths.
Methods and Materials/Patients: We prospectively investigated the two treatment groups, medical (88 patients) and surgical (40 patients), based on standard guidelines between May 2018 and November 2019. Immediate outcomes in the two groups were measured using the Glasgow outcome scale (GOS) at three months. Prognostic factors in the two groups were compared using the chi-square test.
Results: Of 128 patients with spontaneous SICH, 88 were in the medical group, and 40 were in the surgical group. The mean age of the medical group was 57±13 years, and that of the surgical group was 53.7±12 years. In both groups, the predominant bleeding site was the left capsuloganglionic region.
Hypertension was the most common risk factor in both groups (90%). In the medical group (n=88), 57 patients (65%) had good outcomes, and 31 patients (35%) had poor outcomes. In the surgical group (n=40), 19 patients (48%) had good outcomes, and 21 patients (35%) had poor outcomes. Mortality rates were 25% (n=22) in the medical group and 30% (n=12) in the surgical group till 3 months. Patients in our surgical group with intracerebral hemorrhage (ICH) score of 3 had a poorer outcome (68%) and lower mortality (46%) than those in the medical group (66% poor outcome and 55% mortality). The medical group with intraventricular hemorrhage (IVH) (n=28) had poor and good outcomes in 71% and 29% of cases, respectively. The surgical group with IVH (n=20) had poor outcomes in 85% of cases and good outcomes in 15% of cases. The medical and surgical groups without IVH had similar good outcomes in 80% of the cases.
Conclusion: The surgical group had improved outcomes compared to the medical group containing patients with midline shift >6 mm, >30 cc of bleed, and Glasgow coma scale (GCS) 8-12. With higher ICH scores and IVH, the surgical group showed poorer outcomes and fewer deaths.
Article number: 2
Keywords: Supratentorial, Intracerebral
hemorrhage, Glasgow coma
scale, Glasgow outcome
scale (GOS), Decompressive
craniectomy (DC)
Type of Study: Research |
Subject:
Basic Neurosurgery
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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