Up-to-date technologies in surgery of hypertensive intracerebral hemorrhages

Shirshov A.V.

(Research Institute of Neurology of the Russian Academy of Medical Science, Moscow, Russia)

Treatment of patients with intracerebral hemorrhages (IH), conditioned by arterial hypertension (hypertensive IH), demands further improvement. It can be achieved by development of new methods and perfection of conventional ways of surgical treatment of hemorrhagic stroke.

Methods, used in the Neurosurgical Department of the Research Institute of Neurology for treatment of hypertensive IH, include open and stereotactic removal of hematomas, closed external ventricular drainage. CT-guided stereotactic removal of hematomas of lateral or mixed localization (6 cases), stereotactic navigation in open removal of small hematomas (2 cases) were introduced during the last years.

Draining ventricular systems (CNS, Codman, USA; OMB firm, Moscow) were used successfully in 15 patients with medial hemorrhages. These systems allowed to widen indications for ventricular drainage in IH, complicated by outflow of blood into the ventricular system and acute obstructive hydrocephalus.

New ventricular catheters, impregnated with antibiotics, were developed. They reduced risk of development of infectious complications, caused by long-tern drainage.

Thus, new technologies improve not only surgical methods of treatment of intracerebral hemorrhages, but also its results.