Sixty-one cases of hypertensive intracerebral hematomata were evacuated by CT guided stereotactic method. The operation was performed in the CT room under general anesthesia using the KOMAI-NAKAJIMA STEREOTACTIC DEVDCE. This instrument has a micromanipulater that can be used for various kinds of stereotactic procedures. Three dimensional position of the target point (aspiration point of the hematoma) was determined on the film obtained from CT scanning of the patient in the stereotactic system. If the hematoma was small, the target point was enough to be one point at the center of the hematoma, but in case of the large hematoma, several target points were given according to the shape of hematoma. The probe, ordinarily a steel tube 4mm in outer diameter, was inserted through brain to the target point and the hematoma was aspirated through a silicon tube connected to a vacuum system.
Among 61 cases examined, 30 cases of thalamic hemorrhage were operated upon and 36 cases were not operated. They were classified according to the volume of hematoma into 3 groups as follows : A= less than 10ml, B=11-25ml, C=more than 25ml. The operated cases were compared with the non operated cases on the improving of the consciousness in each group.
In the A group, the operated patients in the level I ^* recovered more slowly than the non operated patients, but in the level II^** patients, this was reversed.
In the B group, the operated patients improved more quickly except the level I patients.
In the C group, almost all of non operated patients died. Thus, this operation was very useful in improving of consciousness of level II or III^*** patients independent of hematoma volume. It accelerated the recovery of motor function in the level I.
This non inversive technique in considered effective for the removal of deep intracerebral hematoma.
^*level I : nearly equal 1115 points in G.C.S.
or almost alertness-light somnolence.
^**level II : nearly equal 711 points in G.C.S.
or somnolencestupor.
^***level III : nearly equal 37 points in G.C.S.
or sever stupordeep coma.