Our Group organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.
Spontaneous intracerebral haemorrhage has a high disability
and mortality rate. In cases, when surgery is needed, minimally
invasive approach is recommended.
A 59-year old patient was admitted due to progressive left sided
arm and leg weakness. The neurological status started to deteriorate
quickly. A computed tomography (CT) of the head revealed an ICH
of 7cm in diameter with haematocephalus and cerebral oedema.
The CT angiography was negative, classifying the haematoma
as a primary one. Coagulation and aggregation values were
deranged as a result of liver failure. The international normalised
ratio (INR) and prothrombine time (PT) were lowered to 1.56
and 0.47, respectively. The platelet count was 33 and the platelet
function tests were completely disturbed. Injections of fresh
frozen plasma, recombinant coagulation factor VIIa, protrombin
complex, vitamin K and platelet plasma were applied. As a result
of extensive intracerebral bleeding and consciousness decline,
surgery was recommended despite unfavourable laboratory results.
A minimally invasive approach was chosen for the ICH removal.
A burr hole of 1cm in diameter was made in the right temporal
area. Under the microscope, the liquefied blood was evacuated
with aspirator and bipolar. The ICP values remained normal during
the course of treatment. The control CT scan showed successfully
evacuated haematoma and normal width of the ventricles. The
sedation was gradually discontinued after a week. The patient was
awake with persistent left sided haemiplegia.
In case of patent with numerous risk factors and imminent
operation, minimally invasive surgery for intracerebral haematoma
is warranted.
Biography
Tomaz Velnar, MD, PhD is a neurosurgeon and assistant professor at Ljubljana medical centre. He is also active in research, cooperating regularly with the other two authors. They have started a multicentre study of vitamin D deficiency among older people.
Relevant Topics
Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals