Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke

Mitalip Mamytov; Keneshbek Yrysov

doi:doi:10.11648/j.cnn.20190304.12

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Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke

Mitalip Mamytov, Keneshbek Yrysov

Published in Clinical Neurology and Neuroscience (Volume 3, Issue 4)

Received: 1 October 2019 Accepted: 29 October 2019 Published: 4 November 2019

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Abstract

Background: Until now, nobody has arrived at a general consensus on the timing of operative treatment intervention, depending on the hemorrhage nature, localization and volume and the severity of patient's condition. Objective: To assess the results of operative treatment of patients with hypertension-induced hemorrhagic stroke (HS) in order to determine the optimal times of surgical interventions, thereby improving the results of operative treatment. Methods: The treatment outcome analysis has been performed regarding the patients with hypertensive hemorrhagic stroke (HHS), who underwent surgery operation at the neurosurgery and neurotraumatology departments of the National Hospital of the MH KR. The age of patients ranged from 43 to 76 years. The main etiological factor in all cases was hypertensive disease. Results: The mean age of postoperative patients was 60 years old (the youngest patient was 43 years old and the oldest was 76 years old). Out of the 90 (100%) postoperative patients 74 (82.2%) patients were discharged with improvement, and 16 (17.8%) patients with fatal outcome. And also the fatality rate analysis has been performed depending on the HHS volume and the midline structure dislocation degree. Among the deceased postoperative patients, the distribution by HHS volume was as follows: up to 60 cm3 - 11.5% of cases, from 61 to 80 cm³ - 9.52%, from 81 to 120 cm3 - 22.58% and above 121 cm3 - 33.3%. The deceased patient distribution by the midline structure dislocation degree was as follows: up to 2 mm - in 11.1% of cases, from 3 to 6 mm - in 21%, over 10 mm - in 40%. Also the fatality rate analysis has been performed, depending on the timing of operative treatment. Among the deceased postoperative patients, the distribution by operative treatment times was as follows: 1–3 days 23.7% of cases, 4–6 days 16.6%, 7–9 days 12.5%, 10 days and more - 11.1% (Table 6). Conclusions: The prognostic favorable times for operative treatment of patients having HHS with different localization and volumes (60 cm³-80 cm³), and with different dislocations of midlinebrain structures (from 2 to more than 6 mm) range from 3 days to 15-20 days. And the surgery operation is unjustified for the patients with supratentorial localization of than 120 cm3 in volume with midline structure dislocation of more than 10 mm, and in this case the watchful waiting must be applied.

Published in	Clinical Neurology and Neuroscience (Volume 3, Issue 4)
DOI	10.11648/j.cnn.20190304.12
Page(s)	77-83
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Supratentorial Hemorrhage, Infratentorial Hemorrhage, Glasgow Coma Scale

References

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[3]	Krylov VV, Dashyan VG,. Burov SA. Hemorrhagic stroke surgery. M: Medicine; 2012.
[4]	Mendelow AD, Gregson BA, Fernandes HM. STICH investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trail in Intracerebral Haemorrhage (STICH): a randomised trial, Lancet, 2005; 365, 387-397.
[5]	Mendelow AD, Gregson BA, Rowan EN. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial, Lancet, 2013; 382, 397-408.
[6]	Akhmadiev RN, Banashkevich VE, Totorkulov RI. Experience in application of puncture aspiration removal of non-traumatic intracerebral hematomas in combination with local fibrinolysis, Pacific Medical Journal, 2012; 4, 90-92.
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[10]	King JT Jr, Berlin JA, Flamm ES. Morbidity and mortality from elective surgery for asymptomatic, unruptured, intracranial aneurysms: A meta-analysis. J Neurosurg, 1994; 81, 837-42.
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[16]	Zheng J, Li H, Zhao HX, Guo R, Lin S, Dong W et al. Surgery for patients with spontaneous deep supratentorial intracerebral hemorrhage: A retrospective case-control study using propensity score matching. Medicine (Baltimore), 2016; 95, e3024.
[17]	de Oliveira Manoel AL, Goffi A, Zampieri FG, Turkel-Parrella D, Duggal A, Marotta TR et al. The critical care management of spontaneous intracranial hemorrhage: A contemporary review. Crit Care, 2016; 20, 272.
[18]	Krylov VA, Dash'yan VG, Danilov VA, Godkov IM. Surgical treatment of hypertensive intracerebral hematomas. Neurology journal, 2016; 3, 146-151.
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APA Style

Mitalip Mamytov, Keneshbek Yrysov. (2019). Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clinical Neurology and Neuroscience, 3(4), 77-83. https://doi.org/10.11648/j.cnn.20190304.12

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Mitalip Mamytov; Keneshbek Yrysov. Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clin. Neurol. Neurosci. 2019, 3(4), 77-83. doi: 10.11648/j.cnn.20190304.12

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AMA Style

Mitalip Mamytov, Keneshbek Yrysov. Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clin Neurol Neurosci. 2019;3(4):77-83. doi: 10.11648/j.cnn.20190304.12

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@article{10.11648/j.cnn.20190304.12,
  author = {Mitalip Mamytov and Keneshbek Yrysov},
  title = {Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke},
  journal = {Clinical Neurology and Neuroscience},
  volume = {3},
  number = {4},
  pages = {77-83},
  doi = {10.11648/j.cnn.20190304.12},
  url = {https://doi.org/10.11648/j.cnn.20190304.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20190304.12},
  abstract = {Background: Until now, nobody has arrived at a general consensus on the timing of operative treatment intervention, depending on the hemorrhage nature, localization and volume and the severity of patient's condition. Objective: To assess the results of operative treatment of patients with hypertension-induced hemorrhagic stroke (HS) in order to determine the optimal times of surgical interventions, thereby improving the results of operative treatment. Methods: The treatment outcome analysis has been performed regarding the patients with hypertensive hemorrhagic stroke (HHS), who underwent surgery operation at the neurosurgery and neurotraumatology departments of the National Hospital of the MH KR. The age of patients ranged from 43 to 76 years. The main etiological factor in all cases was hypertensive disease. Results: The mean age of postoperative patients was 60 years old (the youngest patient was 43 years old and the oldest was 76 years old). Out of the 90 (100%) postoperative patients 74 (82.2%) patients were discharged with improvement, and 16 (17.8%) patients with fatal outcome. And also the fatality rate analysis has been performed depending on the HHS volume and the midline structure dislocation degree. Among the deceased postoperative patients, the distribution by HHS volume was as follows: up to 60 cm3 - 11.5% of cases, from 61 to 80 cm3 - 9.52%, from 81 to 120 cm3 - 22.58% and above 121 cm3 - 33.3%. The deceased patient distribution by the midline structure dislocation degree was as follows: up to 2 mm - in 11.1% of cases, from 3 to 6 mm - in 21%, over 10 mm - in 40%. Also the fatality rate analysis has been performed, depending on the timing of operative treatment. Among the deceased postoperative patients, the distribution by operative treatment times was as follows: 1–3 days 23.7% of cases, 4–6 days 16.6%, 7–9 days 12.5%, 10 days and more - 11.1% (Table 6). Conclusions: The prognostic favorable times for operative treatment of patients having HHS with different localization and volumes (60 cm3-80 cm3), and with different dislocations of midlinebrain structures (from 2 to more than 6 mm) range from 3 days to 15-20 days. And the surgery operation is unjustified for the patients with supratentorial localization of than 120 cm3 in volume with midline structure dislocation of more than 10 mm, and in this case the watchful waiting must be applied.},
 year = {2019}
}

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TY  - JOUR
T1  - Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke
AU  - Mitalip Mamytov
AU  - Keneshbek Yrysov
Y1  - 2019/11/04
PY  - 2019
N1  - https://doi.org/10.11648/j.cnn.20190304.12
DO  - 10.11648/j.cnn.20190304.12
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 77
EP  - 83
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20190304.12
AB  - Background: Until now, nobody has arrived at a general consensus on the timing of operative treatment intervention, depending on the hemorrhage nature, localization and volume and the severity of patient's condition. Objective: To assess the results of operative treatment of patients with hypertension-induced hemorrhagic stroke (HS) in order to determine the optimal times of surgical interventions, thereby improving the results of operative treatment. Methods: The treatment outcome analysis has been performed regarding the patients with hypertensive hemorrhagic stroke (HHS), who underwent surgery operation at the neurosurgery and neurotraumatology departments of the National Hospital of the MH KR. The age of patients ranged from 43 to 76 years. The main etiological factor in all cases was hypertensive disease. Results: The mean age of postoperative patients was 60 years old (the youngest patient was 43 years old and the oldest was 76 years old). Out of the 90 (100%) postoperative patients 74 (82.2%) patients were discharged with improvement, and 16 (17.8%) patients with fatal outcome. And also the fatality rate analysis has been performed depending on the HHS volume and the midline structure dislocation degree. Among the deceased postoperative patients, the distribution by HHS volume was as follows: up to 60 cm3 - 11.5% of cases, from 61 to 80 cm3 - 9.52%, from 81 to 120 cm3 - 22.58% and above 121 cm3 - 33.3%. The deceased patient distribution by the midline structure dislocation degree was as follows: up to 2 mm - in 11.1% of cases, from 3 to 6 mm - in 21%, over 10 mm - in 40%. Also the fatality rate analysis has been performed, depending on the timing of operative treatment. Among the deceased postoperative patients, the distribution by operative treatment times was as follows: 1–3 days 23.7% of cases, 4–6 days 16.6%, 7–9 days 12.5%, 10 days and more - 11.1% (Table 6). Conclusions: The prognostic favorable times for operative treatment of patients having HHS with different localization and volumes (60 cm3-80 cm3), and with different dislocations of midlinebrain structures (from 2 to more than 6 mm) range from 3 days to 15-20 days. And the surgery operation is unjustified for the patients with supratentorial localization of than 120 cm3 in volume with midline structure dislocation of more than 10 mm, and in this case the watchful waiting must be applied.
VL  - 3
IS  - 4
ER  -

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Author Information

Mitalip Mamytov

Department of Neurosurgery, Kyrgyz State Medical Academy, Kyrgyzstan, Bishkek
Keneshbek Yrysov

Department of Neurosurgery, Kyrgyz State Medical Academy, Kyrgyzstan, Bishkek

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APA Style

Mitalip Mamytov, Keneshbek Yrysov. (2019). Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clinical Neurology and Neuroscience, 3(4), 77-83. https://doi.org/10.11648/j.cnn.20190304.12

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ACS Style

Mitalip Mamytov; Keneshbek Yrysov. Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clin. Neurol. Neurosci. 2019, 3(4), 77-83. doi: 10.11648/j.cnn.20190304.12

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AMA Style

Mitalip Mamytov, Keneshbek Yrysov. Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke. Clin Neurol Neurosci. 2019;3(4):77-83. doi: 10.11648/j.cnn.20190304.12

Copy | Download

@article{10.11648/j.cnn.20190304.12,
  author = {Mitalip Mamytov and Keneshbek Yrysov},
  title = {Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke},
  journal = {Clinical Neurology and Neuroscience},
  volume = {3},
  number = {4},
  pages = {77-83},
  doi = {10.11648/j.cnn.20190304.12},
  url = {https://doi.org/10.11648/j.cnn.20190304.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20190304.12},
  abstract = {Background: Until now, nobody has arrived at a general consensus on the timing of operative treatment intervention, depending on the hemorrhage nature, localization and volume and the severity of patient's condition. Objective: To assess the results of operative treatment of patients with hypertension-induced hemorrhagic stroke (HS) in order to determine the optimal times of surgical interventions, thereby improving the results of operative treatment. Methods: The treatment outcome analysis has been performed regarding the patients with hypertensive hemorrhagic stroke (HHS), who underwent surgery operation at the neurosurgery and neurotraumatology departments of the National Hospital of the MH KR. The age of patients ranged from 43 to 76 years. The main etiological factor in all cases was hypertensive disease. Results: The mean age of postoperative patients was 60 years old (the youngest patient was 43 years old and the oldest was 76 years old). Out of the 90 (100%) postoperative patients 74 (82.2%) patients were discharged with improvement, and 16 (17.8%) patients with fatal outcome. And also the fatality rate analysis has been performed depending on the HHS volume and the midline structure dislocation degree. Among the deceased postoperative patients, the distribution by HHS volume was as follows: up to 60 cm3 - 11.5% of cases, from 61 to 80 cm3 - 9.52%, from 81 to 120 cm3 - 22.58% and above 121 cm3 - 33.3%. The deceased patient distribution by the midline structure dislocation degree was as follows: up to 2 mm - in 11.1% of cases, from 3 to 6 mm - in 21%, over 10 mm - in 40%. Also the fatality rate analysis has been performed, depending on the timing of operative treatment. Among the deceased postoperative patients, the distribution by operative treatment times was as follows: 1–3 days 23.7% of cases, 4–6 days 16.6%, 7–9 days 12.5%, 10 days and more - 11.1% (Table 6). Conclusions: The prognostic favorable times for operative treatment of patients having HHS with different localization and volumes (60 cm3-80 cm3), and with different dislocations of midlinebrain structures (from 2 to more than 6 mm) range from 3 days to 15-20 days. And the surgery operation is unjustified for the patients with supratentorial localization of than 120 cm3 in volume with midline structure dislocation of more than 10 mm, and in this case the watchful waiting must be applied.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Optimal Times of Carrying Out of Operative Treatment of Patients with Hypertensive Hemorrhagic Stroke
AU  - Mitalip Mamytov
AU  - Keneshbek Yrysov
Y1  - 2019/11/04
PY  - 2019
N1  - https://doi.org/10.11648/j.cnn.20190304.12
DO  - 10.11648/j.cnn.20190304.12
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 77
EP  - 83
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20190304.12
AB  - Background: Until now, nobody has arrived at a general consensus on the timing of operative treatment intervention, depending on the hemorrhage nature, localization and volume and the severity of patient's condition. Objective: To assess the results of operative treatment of patients with hypertension-induced hemorrhagic stroke (HS) in order to determine the optimal times of surgical interventions, thereby improving the results of operative treatment. Methods: The treatment outcome analysis has been performed regarding the patients with hypertensive hemorrhagic stroke (HHS), who underwent surgery operation at the neurosurgery and neurotraumatology departments of the National Hospital of the MH KR. The age of patients ranged from 43 to 76 years. The main etiological factor in all cases was hypertensive disease. Results: The mean age of postoperative patients was 60 years old (the youngest patient was 43 years old and the oldest was 76 years old). Out of the 90 (100%) postoperative patients 74 (82.2%) patients were discharged with improvement, and 16 (17.8%) patients with fatal outcome. And also the fatality rate analysis has been performed depending on the HHS volume and the midline structure dislocation degree. Among the deceased postoperative patients, the distribution by HHS volume was as follows: up to 60 cm3 - 11.5% of cases, from 61 to 80 cm3 - 9.52%, from 81 to 120 cm3 - 22.58% and above 121 cm3 - 33.3%. The deceased patient distribution by the midline structure dislocation degree was as follows: up to 2 mm - in 11.1% of cases, from 3 to 6 mm - in 21%, over 10 mm - in 40%. Also the fatality rate analysis has been performed, depending on the timing of operative treatment. Among the deceased postoperative patients, the distribution by operative treatment times was as follows: 1–3 days 23.7% of cases, 4–6 days 16.6%, 7–9 days 12.5%, 10 days and more - 11.1% (Table 6). Conclusions: The prognostic favorable times for operative treatment of patients having HHS with different localization and volumes (60 cm3-80 cm3), and with different dislocations of midlinebrain structures (from 2 to more than 6 mm) range from 3 days to 15-20 days. And the surgery operation is unjustified for the patients with supratentorial localization of than 120 cm3 in volume with midline structure dislocation of more than 10 mm, and in this case the watchful waiting must be applied.
VL  - 3
IS  - 4
ER  -

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