Stereotactic Evacuation of Hypertensive Intracerebral Hematoma Using Plasminogen Activator

Abstract

Treatment of hypertensive intracerebral hemorrhage has generally been carried out using either surgical evacuation by craniotomy or by conservative therapy. In 1974, Komai et al. [9] demonstrated for the first time that intracerebral hematoma can be safely evacuated by stereotactic technique, and suggested that stereotactic evacuation may become an applicable surgical procedure for hypertensive intracerebral hematoma. In 1980, we reported, for the first time, an extensive series of intracerebral hematomas treated by stereotactic evacuation using a plasminogen activator [1]. This new surgical procedure has since been acknowledged by other authors to be a safe and valuable treatment method for hypertensive intracerebral hematoma [7]. Since 1978, we have treated 241 intracerebral hematomas using the stereotactic approach. We herein report an analysis of our series and offer discussion on several controversial points in the surgical treatment of this disease.