Author/Editor		Strojnik, Tadej
Title		Kirurško zdravljenje spontanih možganskih krvavitev - prikaz zdravljenja 96 bolnikov
Translated title		Surgical management of spontaneous intracerebral hemorrhage - report of management of 96 patients
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 38, št. Suppl 5
Publication year		1999
Volume		str. 105-12
Language		slo
Abstract		Background. Spontaneous intracerebral hemorrhages (ICH) represent only 10% of all strokes, but they account for fully half of stroke-related deaths. Hypertension is the most common sible factor contributing to spontaneous ICH. Patient management can be either medical or operative. The indications for surgical intervention have not been completely clarified; the surgeon must make a decision according to his/her experience and the guidelines for surgical treatment vs. medical management (i.e. with drugs). Methods. The charts of patients treated for spontaneous ICH at the Department of Neurosurgery in Maribor General Hospital between 1972 and 1998 were reviewed. Data concerning age and gender, results of neurological examination upon admission, radiological data, type of management and the outcome were analysed. Results. Ninety-six patients were included in the study. The most common cause of spontaneous ICH was chronic arterial hypertension. Thirty-two patients were treated conservatively, and the others surgically, usually by craniotomy (52 cases). Twenty-two patients died. Upon discharge, 33 patients recovered and 41 had partial or total disability. Conclusions. There remains significant controversy concerning indications for surgical treatment. A group of patients treated at our department are presented in the paper, along with recent treatment for patients with spontaneous ICH.
Summary		Spontana možganska krvavitev povzroča desetino možganske kapi, obenem pa prispeva kar k polovici smrtnih izidov zaradi možganske kapi. Najpogostejši dejavnik tveganja spontane možganske krvavitve je povišan krvni tlak. Zdravljenje bolezni je konzervativno ali operativno, odločitev o izbiri zdravljenja pa je kompleksna in individualna. Temelji naj na sodobnih smernicah za obravnavo bolnika s spontano možgansko krvavitvijo in izkušnjah nevrokirurga. Bolniki, metode in rezultati. Pregledali smo popise bolnikov, ki so se zaradi spontane možganske krvavitve zdravil na Nevrokiruškem oddelku Splošne bolnišnice Maribor v obdobju od 1972 do 1998. Po enotnem pretokolu smo zbrali splošne podatke o bolniku, nevrološki status ob sprejemu, radiološke izvide, način zdravljenja in izhod zdravljenja. Za deskriptivno statistiko in t-teste smo uporabili program Statistika for Windows. Obravnavali smo 96 bolnikov, najpogostejši vzrok krvavitve je bil zvišan krvni tlak. Tretjino bolnikov (32 primerov) smo zdravili konzervativno, ostale pa operativno, običajno s kraniotomijo (52 primerov). Umrlo je 22 bolnikov, med odpuščenimi pa jih je bilo 33 samostojnih in 41 odvisnih pri dnevnih opravilih. Zaključki. Zaradi nedorečenosti pri odločanju o operativnem zdravljenju spontane možganske krvavitve (tudi glede izbire časa operacije) predstavljamo pregled dela na našem oddelku in smernice za zdravljenje spontane možganske krvavitve iz literature. Rezultati študije potrjujejo priporočila, da je treba kirurško pomemben hematom odstraniti čim prej.
Descriptors		CEREBRAL HEMORRHAGE HYPERTENSION TREATMENT OUTCOME