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August 14-16, 2017 | Toronto, Canada

BRAIN DISORDERS AND DEMENTIA CARE

4

th

International Conference on

Neurosurg, an open access journal

ISSN: 2471-9633

T

his was a prospective and interventional type of study

conducted in the Neurosurgery Department of Dhaka

Medical College Hospital (DMCH), Dhaka from July 2010

to December 2010 with a sample size of 30 to observe the

presenting feature, radiological findings and complications

of burr-hole aspiration of intracerebral haematoma by using

urokinase. Purposive sampling technique was used using

a semi-structured data collection sheet designed for this

study. Equipments used for the study were CT scan, soft

catheter and standard burr-hole instrument. It was observed

that 73% of the cases were within 9-12 GCS. Basal ganglia

were involved in about 77% cases while fronto parietal lobe

was involved in only 3% cases. CT scan revealed that half

[15 (50.00%)] of the patient’s haematoma was in the left

hemisphere. Without considering the volume of extension

into the ventricles, the average intracerebral haematoma

volume was 41.43 ml and the volume ranged from 20.0

to 80.0 ml. [18 (60.0%)] of the patients had ventricular

extension of the haematoma. Three-fifth of the haematomas

were complicatedwith ventricular extension. More than one-

fourth of the patients [8 (26.67%)] died before 3rd POD. In a

single (3.33%) patient GCS decreased. Out of the remaining

21 cases, GCS increased 1 to 5 points. Pneumocephalous

was the complication in about 17% cases, while accidental

catheter withdrawal and aspiration pneumonia were the

complications in about 7% each. It was revealed that 50%

deaths were due to respiratory failure and all these deaths

were before 3rd POD. Involvement of different areas of the

cerebral hemisphere had strong association in outcome,

when only death was considered; i.e. only 14.3% patients

with cortical haematoma died on the contrary, 85.7%patients

with ICH in the basal ganglia with ventricular extension (3 or

more ventricles) died. Early treatment (within 24 hours of

occurrence) by using minimally invasive technique and clot

removal by urokinase mediated clot lysis can improve the

consequences especially those with haematoma volume <40

ml, lobar haematoma and without ventricular extension.

e:

drmnh2003@gmail.com

Clinical and radiological presenting features and post-operative complications of intracerebral

haematoma by burr-hole operation using urokinase

Mohammad Nazrul Hossain

1

, Israt Zerin Eva

2

, Junayed Ahmad

1

, Nazmul Hassan Saki1

and

Saniath Ahmad Salehin

1

1

Jalalabad Ragib-Rabeya Medical College Hospital, Bangladesh

2

Dhaka Medical College Hospital, Bangladesh

Neurosurg 2017, 2:2

DOI: 10.21767/2471-9633-C1-006