Document Detail

Gross-total hematoma removal of hypertensive basal ganglia hemorrhages: a long-term follow-up.
MedLine Citation:
PMID:  19801153     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Hypertensive basal ganglia hemorrhage (HBGH) accounts for 35%-44% of cases of hypertensive intracranial hemorrhage (ICH), which is one of the most devastating forms of cerebrovascular disease. In this study, intracerebral hematoma was evacuated with a burr hole craniectomy. The relationships of residue hematoma volume to brain edema, inflammation factors and the long-term prognosis of HBGH patients were studied. METHODS: One hundred and seventy-six patients with HBGH were randomly divided into gross-total removal of hematoma (GTRH) and sub-total removal of hematoma (STRH) groups. The pre-operative and post-operative data of the patients in the two groups were compared. The pre-operative data included age, sex, hematoma volume, time from the ictus to the operation, Glasgow Coma Scale (GCS) scores, and the European Stroke Scale (ESS) scores. The post-operative information included edema grade, level of thromboxane B2 (TXB2), 6-keto-prostaglandin F1a (6-K-PGF1a), tumor necrosis factor-a (TNF-a) and endothelin (ET) in hematoma drainage or cerebral spinal fluid (CSF), ESS and Barthel Index (BI). RESULTS: There was no statistical difference between the two groups (P>0.05) in the pre-operative data. The levels of TXB2, 6-K-PGF1a, TNF-a and ET in the GTRH group were significantly lower than those in the STRH group at different post-operative times. The ESS in the GTRH group increased rapidly after the operation and was higher than that in the STRH group. There was a significant difference between the two groups (P<0.05). The post-operative CT scan at different times showed that the brain edema grades were better in the GTRH group than in the STRH group. The BI was higher in the GTRH group than in the STRH group (P<0.05). CONCLUSIONS: GTRH is an effective method to decrease ICH-induced injury to brain tissue. Such effect is related to decreased perihematomal edema formation and secondary injury by coagulation end products activated inflammatory cascade.
Yi Zuo; Gang Cheng; Da-Kuan Gao; Xiang Zhang; Hai-Ning Zhen; Wei Zhang; San-Chao Xiao
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Publication Detail:
Type:  Journal Article     Date:  2009-10-03
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  287     ISSN:  1878-5883     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-09     Completed Date:  2010-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  100-4     Citation Subset:  IM    
Department of Neurosurgery, Xijing Hospital of the Fourth Military Medical University, Xi'an, China.
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MeSH Terms
6-Ketoprostaglandin F1 alpha / analysis,  blood,  cerebrospinal fluid
Basal Ganglia Hemorrhage / complications,  physiopathology*,  surgery*
Biological Markers / analysis,  blood,  cerebrospinal fluid
Brain Edema / etiology,  pathology,  physiopathology*
Disease Progression
Encephalitis / etiology,  physiopathology*
Endothelins / analysis,  blood,  cerebrospinal fluid
Follow-Up Studies
Glasgow Coma Scale
Hypertension / complications*
Inflammation Mediators / analysis,  blood,  cerebrospinal fluid
Middle Aged
Neurosurgical Procedures / methods
Postoperative Complications / etiology,  physiopathology
Predictive Value of Tests
Thromboxane B2 / analysis,  blood,  cerebrospinal fluid
Time Factors
Treatment Outcome
Tumor Necrosis Factor-alpha / analysis,  blood,  cerebrospinal fluid
Reg. No./Substance:
0/Biological Markers; 0/Endothelins; 0/Inflammation Mediators; 0/Tumor Necrosis Factor-alpha; 54397-85-2/Thromboxane B2; 58962-34-8/6-Ketoprostaglandin F1 alpha

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