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Pain Management 2018
Internal Medicine 2018
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 47
March 26-28, 2018
Vienna, Austria
JOINT EVENT
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Volume 4
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pontaneous intracerebral haemorrhage has a high disability
and mortality rate. In cases, when surgery is needed,
minimally invasive approach is recommended. A 59-year old
patient was admitted due to progressive left sided arm and leg
weakness. The neurological status started to deteriorate quickly.
A computed tomography (CT) of the head revealed an ICH of 7
cm in diameter with haematocephalus and cerebral oedema.
The CT angiography was negative, classifying the haematoma
as a primary one. Coagulation and aggregation values were
deranged as a result of liver failure. The international normalised
ratio (INR) and prothrombine time (PT) were lowered to 1.56 and
0.47 respectively. The platelet count was 33 and the platelet
function tests were completely disturbed. Injections of fresh
frozen plasma, recombinant coagulation factor VIIa, protrombin
complex, vitamin K and platelet plasma were applied. As a result
of extensive intracerebral bleeding and consciousness decline,
surgery was recommended despite unfavourable laboratory
results. A minimally invasive approach was chosen for the ICH
removal. A burr hole of 1 cm in diameter was made in the right
temporal area. Under the microscope, the liquefied blood was
evacuated with aspirator and bipolar. The ICP values remained
normal during the course of treatment. The control CT scan
showed successfully evacuated haematoma and normal width
of the ventricles. The sedation was gradually discontinued
after a week. The patient was awake with persistent left sided
haemiplegia. In case of patient with numerous risk factors and
imminent operation, minimally invasive surgery for intracerebral
haematoma is warranted.
Biography
Tomaz Velnar, MD, PhD is a Neurosurgeon and Assistant Professor at Lju-
bljana Medical Centre. He is also active in research, cooperating regularly
with the other two authors. They have started a multicentre study of vitamin
D deficiency among older people.
tvelnar@hotmail.comNon-endoscopic minimally invasive
evacuation of intracerebral haematoma
Tomaz Velnar
1, 2
1
University Medical Centre Ljubljana, Slovenia
2
Alma Mater Europaea University Maribor, Slovenija
Tomaz Velnar, Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-002