BOON SENG LIEW, Azmin Kass Rosman, Johari Siregar Adnan, Outcome in Patients with Spontaneous Primary Intracranial Hemorrhage who underwent Craniotomy Affiliation, Journal of Brain And Spinal Cancer, Volume 1, Issue 1, 2016, Pages 19-28, ISSN 2576-182X, https://doi.org/10.14302/issn.2576-182X.jbsc-16-1261.
(https://oapgroup.org/jbsc/article/364)
Abstract: Background: Spontaneous primary intracranial hemorrhage or known as intracerebral hypertensive hemorrhage consist of 15 to 20% of all stroke, is one of the major health problems among healthy and productive workforce in any countries. Methods: A retrospective study was conducted in a dedicated Neurosurgical Centre at the Hospital Sungai Buloh, Malaysia. The study was conducted for admission within a year period, in the year 2013 with 6 months follow-up. A total of 35 patients were studied. Results: The mean age was 52.8 years old (31-77 years old). A total of 29 patients (82.9%) were presented with basal ganglia hemorrhage, 4 with cerebral lobar hemorrhage (11.4%) and 2 with cerebellar hemorrhage (5.7%). The surgical mortality rate was 40%. For the 6 months follow-up, 31.4% patients improved to Glasgow Outcome score (GOS) of 4, while 22.9% and 5.7% patients improved to only GOS of 3 and 2 respectively. There were several factors identified in the study to be important predictors of survival. There were statistically significance of higher mortality rate among patients with pre-operative GCS of 5 and below (p=0.015), pre-operative CT scan brain showing acute hydrocephalus (p=0.046) and residual post-operative hematoma above 5% of pre-operative clots volume (p=0.006). Other factors such as age, sex, size of pre-operative hematomas, presence of intraventricular hemorrhage, underlying medical illness were not statistically significant in predicting the surgical outcome of those patients. Conclusions: Outcome predictors such as pre-operative GCS and CT scan brain findings helps treating neurosurgeons to determine the prognosis of patients presented with spontaneous intracranial hemorrhage.
Keywords: Spontaneous Primary Intracranial Hemorrhage; Craniotomy; outcome