Outcome of decompressive craniectomy and hematoma evacuation treatment for spontaneous supratentorial intracerebral hemorrhage

Abstract

Background: Patients with spontaneous supratentorial intracerebral hemorrhage who had large hematomas, seriously edema and high intracerebral pressure showing a poor prognosis, with mortality rate is very high. Surgical decompressive craniectomy evacuation hematoma treatment (DCEH) effectively reduce high intracranial pressure. However, some studies show that have no overall benefit of functional outcome and mortality. Objective: To assess some prognostic factors and outcome of surgical decompressive craniectomy evacuation hematoma treatment (DCEH) for spontaneous supratentorial intracerebral hemorrhage. Subject and method: Observational study in 30 patients with supratentorial intracerebral hemorrhage who were performed DCEH at Stroke Center - 108 Military Central Hospital from 1/2016 to 7/2020. Outcome was evaluated in the 6^th months after stroke. Result and conclusion: The mean age in study was 55.8 ± 10.7 years, which age under 60 was 73.3%. The mortality rate after 6 months was 29.4% while the survival rate was 60%. Favourable outcome was shown in mRS range from 0 to 3, accounted for 33.3% compared with 66.7% in the unfavourable outcome group. Main factors which affected to the results were the volume of the hematoma, the midline compression, the damage of internal capsule, the level of blood in ventricles, the Graeb, ICH, and mICH scales.