The effect of hematoma removal for reducing the development of brain edema in cases of putaminal hemorrhage

Abstract

Surgical intervention in putaminal hemorrhage has been a controversial issue. The aim of this research is to evaluate the benefits of surgery for reducing the development of brain edema. Sixteen cases of putaminal hemorrhage were examined. Eight patients were treated conservatively (C group), and the other 8 patients were treated surgically (S group). Head CT scans were performed on the day of onset (day 0) in C group or performed just after surgery (day 0) in S group, and performed again once per period on days 1-7, 8-14, and 15-21. The volume of the mass including hematoma and edema (H + E) was measured using CT scans and the (H + E)/H0 ratios were calculated (H0; hematoma volume on day 0). The (H + E)/H0 ratios for each period were compared statistically between the 2 groups using a t-test. The mean values of (H + E)/H0 ratios at each period were 2.19, 2.63, 2.53 in C group, and 1.29, 1.29, 0.66 in S group. The values in S group were significantly lower as compared with C group in every period (p < 0.01, <0.05, <0.01). Hematoma volume reduction by surgery reduced the development of brain edema. © 2006 Springer-Verlag.