It evaluated the efficacy of percutaneous needle aspiration(PNA) in the evacuation of supratentorial hematoma in 22 patients with spontaneous intracerebral hemorrhage. All PNA patients had hematoma volume greater than 30ml as determined by computerized tomography image analysis. All patients underwent PNA within 12 hours of presentation. No perioperative complications were noted.
In intracerebral hemorrhage patients with hematoma volume > 30ml, survival was higher in patients who underwent PNA than in unmatched medically treated controls.
Survival was significantly higher in patients with 40%, or greater reduction in hematoma volume postevacuaton.
PNA may be a simple and effective method for improving outcome in intracerebral hemorrhage. It appears that survival may be related to the amount of blood removed during PNA.
, Young-Sun kim, Sa-Young Park, Jin-Hyuk Choi, Soon-Nam Lee, Hwa-Soon Chung Thrombohemorrhagic complications in chronic myeloproliferative disease(CMPD) including chronic myelogenous leukemia(CML) are not rare. Lower incidence of disordered hemostasis is reported in CML compared with other CMPD. The mechanism of thrombohemorrhagic complications might be a consequence of qualitative platelet abnormalites and prolonged bleeding time rather than that of thrombocytosis. Although defect of platelet function has been extensively investigated, there was no established consistent correlation between clinical bleeding and number and function of platelet. The most common site of bleeding complications in the CMPD is superficial mucosa. Bleeding in deep tissue and viscera is very unusual. We report a case of CML which developed a huge spontaneous retroperitoneal hematoma.
Twelve cases of delayed traumatic intracerebral hematoma(DTICH) were found retrospectively among 826 patients with closed head injuries admitted to the Department of Neurosurgery, College of Medicine, Ewhe Womans University in a 2-year period. All cases had severe head injuries sustained with the head in motion. The interval from cranial injury to diagnosis of DTICH by computerized tomography(CT) varied from 15 hours to 11 days. The diagnosis was made on repeat CT scans obtained because of the development of focal findings, lack of improvement and/or general neurological deterioration. One patient had initially negative CT scans. Six patients demonstrated only extracerebral hematoma on initial CT scans. Two patients showed acute intracerebral hematoma on the initial scan followed by new hematomas on repeat study. Ten patients were treated surgically, and eight had fair & good results. The cases presented are discussed in the light of pertinent literature.
, Seong Yong Woo, Byeong Ho Lee, Sung Bae An, Jang Wook Lee, Hyun Jong Oh, Suk Joon Park With increase of endoscopy, physical trauma including endoscopic procedure can develop gastric submucosal hematoma. Symptoms are usually abdominal pain, vomiting, fever and bloody stool due to upper GI tract obstruction and complications like intestinal obstruction or peritonitis. Diagnosis is usually made by CT, trans-esophageal sonogram and patients with no intestinal obstruction or peritonitis complications and good general condition usually recover with only conservative treatment. Authors have experienced submucosal hematoma developed after submucosal epinephrine injection with intent to uplift distal lesion in gastric polypectomy and improved with conservative treatment.
Chronic subdural hematoma(CDH) is collection of encapsulated ligified hematoma in subdural space and familiar with neurosurgens. 50 patients of CDH were treated using burr holes and closed-system drainage. The study is a retrospective clinical analysis and reviewed of the surgical method.
Between 1995 and 2001, 50 patients with CDH had surgical treatments, using burr holes and closed-system drainage technique at the department of neurosurgery, Ewha Uninversity Medical Center, Mok-Dong hospital. Mean age was 61 years with a range 35-82 years. The male/female ratio is 41/9. Diagnosis of CDH was confirmed by CT scans. The author divided into 2 groups ; traumatic group and atraumatic group. Retrospectively the author analysed the clinical data regarding age group, sex ratiso, etiology, neurologic grade at admission, post-operative outcomes and outcomes according to neurologic grade at admission. These clinical data compared the traumatic group with atraumatic group.
The number of patients were 27 in traumatic group and 23 in atraumatic groups. The mean age in traumatic and atraumatic groups was 60 years respectively. These lesions generally occur in elderly with the average 61 years. The male/female ratio 21/6 in traumatic group and 20/3 in atraumatic group. Generally it was predominent in male patients. The causes in atraumatic group were hypertension(2 patients), CVA(3 patients) and the others remain unknown. The neurologic grade at admission ; 0 grade 26(male/female=21/5, 1 grade) 7(m/f=6/1), 2 grade 14(m/f=11/3). The outcome scale according to glasgow scale ; 5 scale 31(m/f=24/7), 4 scale 15(m/f=13/2) and 3 scale 4(m/f=4/0). The outcome scale according to neurologic grade at admission was that the more neurologic grade is good, the more outcome is better.
The burr holed and closed system drainage technique is simple, mininal risk, and results in good recovery with short days of admision. This technique is considered as first choice for the evacuation of hematoma of CDH.
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