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Three-dimensional computed tomography-guided multitract aspiration of extensive ganglionic hemorrhage: technical note

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Author(s)
Chang-Young LeeMan-Bin YimJung-Bum KimIl-Man Kim
Keimyung Author(s)
Kim, ElYim, Man BinLee, Chang YoungKim, Jung Bum
Department
Dept. of Neurosurgery (신경외과학)
Dept. of Psychiatry (정신건강의학)
Brain Research Institute (뇌연구소)
Journal Title
Surgical Neurology
Issued Date
2005
Volume
64
Issue
6
Keyword
Intracerebral hemorrhageStereotactic aspirationPutaminal hematomaFibrinolysis3-Dimensional computed tomographyAngiography
Abstract
Background: We describe a methodology for effectively improving the lysis and drainage of
intracerebral hematomas during stereotactic surgery.
Methods: Stereotactic aspiration using a multitrack technique was performed in 20 patients with
ganglionic hemorrhages perforating into the subcortex. Using 3-dimensional computed tomography
(3D-CT) guidance, the trajectories and targets of hematoma drainage were selected to extract most
portions of the irregular and expansive intracerebral hematomas. Volumes ranged from 36 to 60 mL
(mean, 45 mL). Four to 5 drains were inserted into the parenchymal and ventricular clots. Aspiration
and injections of urokinase (5000 IU) were repeated every 2 to 3 hours until the hematoma was
almost completely removed.
Results: The intended catheters for hematoma aspiration were placed precisely along the
predetermined tracks with the aid of 3D-CT visualization. The deep and subcortical hematomas
were totally removed within a mean of 10 hours postoperatively. Multiple catheter placements itself
caused no complications. Sixteen patients (80%) recovered with a favorable neurological outcome.
Conclusions: The 3D-CT–based multitrack technique is a rapid and effective method for the
stereotactic removal of extensive ganglionic hemorrhages. It has the advantage of giving better
neurological recovery than conventional stereotactic or microscopic surgery for selected patients.
D 2005 Elsevier Inc. All rights reserved.
Keywords: Intracerebral hemorrhage; Stereotactic aspiration; Putaminal hematoma; Fibrinolysis; 3-Dimensional computed
tomography; Angiography
Keimyung Author(s)(Kor)
김엘
임만빈
이창영
김정범
Publisher
School of Medicine
Citation
Chang-Young Lee et al. (2005). Three-dimensional computed tomography-guided multitract aspiration of extensive ganglionic hemorrhage: technical note. Surgical Neurology, 64(6), 519–524. doi: 10.1016/j.surneu.2005.03.037
Type
Article
ISSN
0090-3019
Source
https://www.sciencedirect.com/science/article/pii/S0090301905002168?via%3Dihub
DOI
10.1016/j.surneu.2005.03.037
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34452
Appears in Collections:
3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
1. School of Medicine (의과대학) > Dept. of Psychiatry (정신건강의학)
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