The Effect of Hematoma Removal for Reducing the Development of Brain Edema in Cases of Putaminal Hemorrhage

Introduction: Surgical intervention in putaminal hemorrhage has been a controversial issue. The aim of this research is to evaluate the benefits of surgery for reducing the development of brain edema.

Materials And Methods: Sixteen cases of putaminal hemorrhage were examined. Eight patients were treated conservatively (C group), and the other 8 patients were treated surgically (S group). Head CT scans were performed on the day of onset (day 0) in C group or performed just after surgery (day 0) in S group, and performed again once per period on days 1-7, 8-14, and 15-21. The volume of the mass including hematoma and edema (H + E) was measured using CT scans and the (H + E)/H0 ratios were calculated (H0; hematoma volume on day 0). The (H + E)/H0 ratios for each period were compared statistically between the 2 groups using a t-test.

Results: The mean values of(H + E)/H0 ratios at each period were 2.19, 2.63, 2.53 in C group, and 1.29, 1.29, 0.66 in S group. The values in S group were significantly lower as compared with C group in every period (p < 0.01, < 0.05, < 0.01).

Conclusions: Hematoma volume reduction by surgery reduced the development of brain edema.