Intraoperative ultrasonographic-guided surgery of intracerebral hemorrhage

Abstract

Abstract Background The location of the cortical incision and maximum evacuations of parenchymal intracerebral hematoma are crucial points. Intraoperative ultrasonography is a real-time tool with great benefit at these points Methods A retrospective study of patients with parenchymal intracerebral hemorrhage that underwent evacuation using intraoperative ultrasound guidance was included. Preoperative clinical and radiological assessments were studied. The postoperative imaging and clinical outcome were assessed. A late follow-up after 6 months was done. Results The age of study patients ranged from 9 to 73 (mean 45.3 ± 20.4 years). There were 14 males (58.3%). The mean preoperative Glasgow Coma Scale (GCS) was 9.8 ± 2.9. The preoperative hematoma volume ranged from 32 to 135 cm3 with a mean of 68.5 ± 30.5 cm3. The rate of evacuation ranged from 90 to 100%. The mean postoperative GCS was 11.7 ± 2.5. None of the patients had a recurrent hemorrhage. There was a significant rate of evacuation of the hematomas (P value < 0.001*). Also, there was a marked improvement in postoperative GCS and the late modified Rankin Scale (P value < 0.001*). Conclusion Ultrasonography is a useful, efficient, real-time tool for the localization and evacuation of parenchymal intracerebral hemorrhage. It maximizes evacuation and decreases parenchymal insult. It is an important aid to the neurosurgeon.

Keywords

• Intracerebral hemorrhage
• Intraoperative ultrasound
• CT scan
• Real-time
• Evacuation