Prognostic Factors and Surgical Indications in Spontaneous Lobar and Putaminal Hematomas

  • A. Krone
  • M. Glaser
  • D. Pfeuffer-Hess
  • U. Bogdahn
  • I. Haubitz
  • E. Hofmann
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 21)


Since McKissock et al. published their historical study in 1961 [9] which showed no benefit from surgical treatment, the role of surgery in the treatment of spontaneous intracerebral hematomas has remained a matter of debate. After the introduction of computed tomography (CT) still no generally recognized criteria for a surgical indication are available despite several recent studies [1,4, 5, 7, 10]. Facing the ethical problems of a prospective randomized trial the following questions were investigated by a retrospective clinical study: What is the impact of clinical and radiological factors on patients outcome? Are there subgroups defined by these prognostic parameters which are significantly different after conservative or surgical treatment?


Intracerebral Hemorrhage Prospective Randomized Trial Surgical Indication Comatose Patient Hematoma Volume 
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  1. 1.
    Auer LM, Deinsberger W, Niederkorn K, Gell G, Kleinert R, Schneider G, Holzer P, Bone G, Mokry M, Körner E, Kleinert G, Harnisch S (1989) Endoscopic surgery versus medical treatment for spontaneous intraeerebral hematoma: a randomized study. J Neurosurg 70:530–535PubMedCrossRefGoogle Scholar
  2. 2.
    Bogdahn U, Wortmann B, Boenighaus K, Haubitz I, Martin R, Kuhn W, Ratzka M, Mertens HG (1989) Prognostische Faktoren bei spontanen supratentoriellen Blutungen. In: Bogdahn U, Mertens HG (eds) Prognostik in der Intensivtherapie des Zentralnervensystems. Springer, Berlin Heidelberg New York, pp 112–123Google Scholar
  3. 3.
    Helweg-Larsen S, Sommer W, Strange P, Lester J, Boysen G (1984) Prognosis for patients treated conservatively for spontaneous intraeerebral hematomas. Stroke 15:1045–1048PubMedCrossRefGoogle Scholar
  4. 4.
    Hungerbühler JP, Regli F, Van Melle G, Bogousslavsky J (1983) Spontaneous intracerebral haemorrhages (SICHs). Clinical and CT features; immediate evaluation of prognosis. Arch Suis Neurol Neurochir Psychiatr 132:13–27Google Scholar
  5. 5.
    Juvela S, Heiskanen O, Poranen A, Valtonen S, Kuurne T, Kaste M, Troupp H (1989) The treatment of spontaneous intraeerebral hemorrhage. A prospective randomized trial of surgical and conservative treatment. J Neurosurg 70:755–758PubMedCrossRefGoogle Scholar
  6. 6.
    Kanaya H (1990) Results of conservative and surgical treatment in hypertensive intraeerebral hemorrhage-cooperative study in Japan. Jpn J Stroke 12:509–524CrossRefGoogle Scholar
  7. 7.
    Kaneko M, Tanaka K, Shimada T, Sato K, Uemura K (1983) Long-term evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J Neurosurg 58:838–842PubMedCrossRefGoogle Scholar
  8. 8.
    Kanno T, Sano H, Shinomiya Y, Katada K, Nagata J, Hoshino M, Mitsuyama F (1984) Role of surgery in hypertensive intracerebral hematoma. A comparative study of 305 non-surgical and 154 surgical cases. J Neurosurg 61:1091–1099PubMedCrossRefGoogle Scholar
  9. 9.
    McKissock W, Richardson A, Taylor J (1961) Primary intracerebral hemorrhage. A controlled trial of surgical and conservative treatment in 180 unselected cases. Lancet II: 221–226CrossRefGoogle Scholar
  10. 10.
    Volpin L, Cervellini P, Colombo F, Zanusso M, Benedetti A (1984) Spontaneous intracerebral hematomas: a new proposal about the usefulness and limits of surgical treatment. Neurosurgery 15:663–666PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • A. Krone
    • 1
  • M. Glaser
    • 1
  • D. Pfeuffer-Hess
    • 1
  • U. Bogdahn
    • 2
  • I. Haubitz
    • 3
  • E. Hofmann
    • 4
  1. 1.Neurochirurgische Klinik und PoliklinikUniversität WürzburgWürzburgGermany
  2. 2.Neurologische Klinik und PoliklinikUniversität WürzburgWürzburgGermany
  3. 3.RechenzentrumUniversität WürzburgWürzburgGermany
  4. 4.Abteilung für NeuroradiologieUniversität WürzburgWürzburgGermany

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