Spontaneous Intracerebral Haematomas
Advances in Diagnosis and Therapy
Published on 1. December 1980
Book
Hardback
XVI, 418 pages
978-3-540-10146-8 (ISBN)
Description
Spontaneous intracerebral haemorrhages are the most dangerous complication of cerebral vascular disease. Because of their frequency and the fact that they lead to serious injuries, prolonged disabilities and, often, death, they have acquired an enormous significance, both medically and socially. Their precise diagnosis, location, wide extent and accomp~ying manifestations were for a very long time uncertain and, in small and deeply situated haematomas, these factors were impossible to determine. Diagnosis was confirmed by the clinical picture, by angiography and sometimes by ventriculography and included, in the main, both lobar and more extensive haematomas. The results of operative treatment following the first attempt of H. Cushing in 1903 were poor and remained unsatisfactory in spite of the endeavours of numerous authors (Guillaume et al. 1956; Lazorthes 1956; McKissock et al. 1959; Luessenhop 1967 and many others). Especially for the most frequent and typically hypertensive haematomas in the region of the internal, capsule, the opinion was often expressed that operative treatment was useless.
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Advances in Diagnosis and Therapy
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Advances in Diagnosis and Therapy
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Content
1 Special Lecture.- Stroke.- 2 Morphology and Aetiology.- 2.1 Pathology and Aetiology of ICH.- 2.2 Haemorrhage and Haematoma - Morbid Anatomy.- 2.3 Diagnosis and Control of Bleeding Disorders.- 2.4 ICH in Clotting Disorders.- 2.4.1 Discussion: Anticoagulants and ICH.- 2.5 Micro-angiomas and ICH.- 2.5.1 Discussion: Micro-angiomas.- 2.6 ICH in Childhood.- 2.7 Familial Incidence of ICH.- 2.8 ICH in Sinus and Cerebral Vein Thrombosis.- 2.9 Role of Traumain ICH.- 2.9.1 ICH After Minor Trauma.- 2.9.2 Trauma in Intracerebral Haematomas.- 2.9.3 Relationship Between Head Injuries and Intracerebral Haematoma.- 2.9.4 Delayed Traumatic Apoplexy.- 2.9.4.1 Discussion.- 2.10 Haematomas of Unknown Aetiology.- 2.11 Stroke and ICH in Spontaneously Hypertensive Rats.- 3 Epidemiology.- 3.1 Epidemiology of ICH in Europe.- 3.2 Epidemiology of Hypertensive ICH in Japan.- 3.3 ICH and their Aetiology in India.- 3.4 WHO Statistics of Mortality in ICH.- 4 Clinical Pathology.- 4.1 Cerebral Blood Flow in ICH (Is Outcome Determined by Irreversible Haemodynamic Factors?).- 4.2 Intracranial Pressure in ICH.- 4.2.1 Discussion.- 4.3 Sequential Changes in Tissue Surrounding ICH.- 4.3.1 Discussion.- 4.4 Brain Abscess Following ICH.- 5 Aetiological Aspects of Location.- 5.1 Pathology and Aetiology of Supratentorial Haemorrhage.- 5.2 Haematomas in Hemispheric Lobes.- 5.3 Intraventricular Haematoma and Haemorrhage.- 5.3.1 Discussion.- 5.4 Correlation Between Ventricular Haemorrhage and Chronic Cerebral Ischaemia in Adult Moya-Moya.- 5.5 Cerebellar Haematomas.- 5.5.1 Discussion.- 5.6 Spontaneous Brain Stem (Pontine) Haematomas.- 5.6.1 Primary Brain Stem Haematoma.- 6 Diagnosis.- 6.1 Angiography in ICH.- 6.1.1 Differential Diagnosis of ICH.- 6.1.2 The Role of Angiography in the Neuroradiological Diagnosis of Intracerebral Haematomas.- 6.1.3 Discussion.- 6.2 Computerized Tomography (CT) in ICH.- 6.2.1 Diagnosis and Differential Diagnosis of Spontaneous ICH with CT Scan.- 6.2.2 Automatic and Quantitative Diagnosis of ICH by CT.- 6.2.3 Intraventricular Haemorrhages in CT Scans.- 6.2.4 Brain Stem Haemorrhage.- 6.2.5 CT in Traumatic ICH - Measurement of Absorption Values.- 6.2.6 Natural History and Follow-Up.- 7 Conservative Treatment.- 7.1 The Immediate Care of Stroke.- 7.2 Conservative Therapy of Spontaneous ICH.- 7.3 Rehabilitation after Acute ICH.- 7.3.1 Rehabilitation after Spontaneous ICH.- 7.3.2 Discussion.- 7.4 Initial Clinical Course and Prognostic Factors in ICH.- 7.5 Late Prognosis.- 7.5.1 Discussion.- 8 Operative Treatment.- 8.1 General Surveys.- 8.1.1 Experiences with Operation in 149 Cases of Spontaneous ICH (1966-1977).- 8.1.2 Experiences with the Surgical Treatment of 156 ICH (1955-1977).- 8.1.3 Experience with the Treatment of 48 Hypertensive ICH (1968-1978).- 8.1.4 Surgery in Spontaneous ICH.- 8.1.5 Spontaneous ICH - Prognosis and Discussion.- 8.2 Grading and Timing.- 8.2.1 Grading and Timing of Operative Treatment.- 8.2.2 Grading and the Indications for Treatment in ICH of the Basal Ganglia (Cooperative Study in Japan).- 8.2.3 Grading and Timing of Operation in Putaminal ICH.- 8.2.4 Discussion.- 8.3 Aetiology - Indications and Prognosis.- 8.3.1 Hypertensive ICH.- 8.3.1.1 Possibilities of Operative Treatment and its Limitations.- 8.3.1.2 Indications and Contra-Indications.- 8.3.1.3 Discussion.- 8.3.1.4 Prognostic Factors in the First 48 Hours in Spontaneous ICH and Spreading Haemorrhages.- 8.3.1.5 Haemorrhage and Haematoma.- 8.3.2 Clotting Disorders.- 8.3.2.1 Indications and Prognosis.- 8.3.2.2 Haematomas Due to Anticoagulant Treatment.- 8.3.3 Traumatic ICH.- 8.3.3.1 Comparative Study of the Results in Spontaneous and Traumatic ICH.- 8.3.3.2 Indications and Operative Treatment of Traumatic ICH.- 8.3.3.3 Prognosis in Traumatic ICH.- 8.4 Location - Indications and Prognosis.- 8.4.1 Haematomas in Hemispheric Lobes.- 8.4.2 Intraventricular ICH.- 8.4.2.1 Surgical Treatment.- 8.4.2.2 Location, Indication and Prognosis.- 8.4.2.3 CT Scan and Treatment.- 8.4.3 Basal Ganglia and Thalamus.- 8.4.3.1 Indication for Operative Treatment of Hypertensive ICH in the Basal Ganglia and Thalamus.- 8.4.3.2 Putaminal ICH with Regard to its Size in CT Scanning.- 8.4.3.3 Trans-Sylvian Approach in Putaminal ICH with Mild Symptoms.- 8.4.3.4 Discussion.- 8.4.4 Cerebellar Haematomas.- 8.4.4.1 Indications and Prognosis.- 8.4.4.2 Indications and Contra-Indications for Operation in Primary Haematomas of the Cerebellum and Brain Stem.- 8.4.4.3 Operative Treatment.- 8.4.4.4 Intracerebellar Haematoma.- 8.4.4.5 Operative Treatment.- 8.4.5 Brain Stem Haematomas.- 8.4.5.1 Clinical Aspects with Reference to Indications for Treatment.- 8.5 Special Technical Problems.- 8.5.1 General Remarks.- 8.5.2 Craniotomy.- 8.5.3 Burr-Hole Evacuation.- 8.5.3.1 Discussion.- 8.5.4 Operative Technique in Putaminal and Thalamic ICH.- 8.5.4.1 Trans-Sylvian Approach to Putaminal Haematomas.- 8.5.5 Continuous Ventricular Drainage.- 8.5.5.1 Technical Note.- 8.5.6 Shunt Operations.- 9 Conclusions.- 9.1 Conservative and Surgical Management.- 9.2 Prospects. The Editors.- 10 References.- 11 Subject Index.