高血压脑出血患者的手术治疗：手术时机与预后
摘要
背景和目的：在目前已发表的相关研究中，对于高血压高出血手术治疗最佳时机的选择仍没有最终定论。本研究的目的是探讨超早期和早期手术对老年组和中年组高血压脑出血(hypertensive intracerebral hemorrhage．Hypertensive ICH)患者预后的影响。
方法：高血压脑出血患者分为老年组(60—83岁)和中年组(39—59岁)。在入选的103位患者中，老年组中26位患者(45.6％)及中年组中22位患者(47.8％)行超早期手术治疗(发病7小时内)；而老年组中31位患者(54.4％)及中年组中24位患者(52.2％)则接受了早期手术治疗(发病7—48小时)。术后通过日常生活能力评分表(activity of daily living. ADL)对患者的预后进行评价。结果：在老年组患者中，超早期手术的死亡率(11.5％)较早期手术(32.2％)为低。经超早期手术的患者中ADL评分为I级的为11人(42.3％)，明显高于经早期手术的6人(19.3％)。尽管如此，在中年组患者中，超早期和早期手术的预后无明显差别。
结论：对于老年高血压脑出血患者，与早期手术相比，超早期手术可获得更好的预后。但此结论不适于中年高血压脑出血患者。
Background and Purpose—Only limited clinical data are available from studies addressing the issue of optimal timing for surgical treatment of hypertensive ICH. The purpose of this study was to investigate the effect of ultra-early or early surgical treatment on outcome of aged and middle-aged patients with hypertensive ICH.
Methods—Patients with hypertensive ICH were classified into aged (range 60 to 83 years old) and middle-aged (range from 39 to 59 years old) groups. Of 103 patients, 26 (45.6%) in the aged group and 22 (47.8%) in the middle-aged group underwent ultra-early surgical treatment (within 7 hr), while 31 (54.4%) in the aged group and 24 (52.2%) in the middle-aged group were treated by early surgical management (within 7-48 hr). The activity of daily living (ADL) measure was used to assess the outcome of patients with hypertensive ICH after surgery.
Results—Mortality in the aged group was lower after ultra-early (11.5%), compared with early surgical treatment (32.2%). In addition, after ultra-early surgery, the number of patients with grade I in the aged group was 11 (42.3%), which was significantly more than 6 (19.3%), who had early surgery. However, there was no statistically significant difference in outcome in the middle-aged group after ultra-early compared with early surgical treatment.
Conclusions—Ultra-early surgical treatment results in better outcome in comparison to early surgical treatment for aged, but not for middle-aged patients with hypertensive ICH.
方法：高血压脑出血患者分为老年组(60—83岁)和中年组(39—59岁)。在入选的103位患者中，老年组中26位患者(45.6％)及中年组中22位患者(47.8％)行超早期手术治疗(发病7小时内)；而老年组中31位患者(54.4％)及中年组中24位患者(52.2％)则接受了早期手术治疗(发病7—48小时)。术后通过日常生活能力评分表(activity of daily living. ADL)对患者的预后进行评价。结果：在老年组患者中，超早期手术的死亡率(11.5％)较早期手术(32.2％)为低。经超早期手术的患者中ADL评分为I级的为11人(42.3％)，明显高于经早期手术的6人(19.3％)。尽管如此，在中年组患者中，超早期和早期手术的预后无明显差别。
结论：对于老年高血压脑出血患者，与早期手术相比，超早期手术可获得更好的预后。但此结论不适于中年高血压脑出血患者。
Background and Purpose—Only limited clinical data are available from studies addressing the issue of optimal timing for surgical treatment of hypertensive ICH. The purpose of this study was to investigate the effect of ultra-early or early surgical treatment on outcome of aged and middle-aged patients with hypertensive ICH.
Methods—Patients with hypertensive ICH were classified into aged (range 60 to 83 years old) and middle-aged (range from 39 to 59 years old) groups. Of 103 patients, 26 (45.6%) in the aged group and 22 (47.8%) in the middle-aged group underwent ultra-early surgical treatment (within 7 hr), while 31 (54.4%) in the aged group and 24 (52.2%) in the middle-aged group were treated by early surgical management (within 7-48 hr). The activity of daily living (ADL) measure was used to assess the outcome of patients with hypertensive ICH after surgery.
Results—Mortality in the aged group was lower after ultra-early (11.5%), compared with early surgical treatment (32.2%). In addition, after ultra-early surgery, the number of patients with grade I in the aged group was 11 (42.3%), which was significantly more than 6 (19.3%), who had early surgery. However, there was no statistically significant difference in outcome in the middle-aged group after ultra-early compared with early surgical treatment.
Conclusions—Ultra-early surgical treatment results in better outcome in comparison to early surgical treatment for aged, but not for middle-aged patients with hypertensive ICH.
引文
1. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001; 344: 1450-1460
2. Diringer MN. Intracerebral hemorrhage: Pathophysiology and management. Crit Care Med. 1993; 21: 1591-1603
3. Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993; 78: 188-191
4. Kanno T, Nagata J, Nonomura K, Asai T, Inoue T, Nakagawa T, Mitsuyama F. New approaches in the treatment of hypertensive intracerebral hemorrhage. Stroke. 1993; 24: 196-100; discussion 1107-108
5. Kaya RA, Turkmenoglu O, Ziyal IM, Dalkilic T, Sahin Y, Aydin Y. The effects on prognosis of surgical treatment of hyportensivc putaminal hematomas through transsylvian transinsular approach. Surg Ncurol. 2003; 59: 176-183; discussion 183
6. Liliang P-C, Liang C-L, Lu C-H, Chang H-W, Cheng C-H, Lee T-C, Chen H-J. Hypertensive caudate hemorrhage prognostic predictor, outcome, and role of external ventricular drainage. Stroke. 2001; 32: 1195-1200
7. McKissock W, Richardson A, Walsh L. Anterior communicating aneurysms: A trial of conservative and surgical treatment. Lancet. 1965; 34: 874-876
8. Fernandes HM, Gregson B, Siddique S, Mendelow AD. Surgery in intracerebral hemorrhage: The uncertainty continues. Stroke. 2000; 31: 2511-2516
9. Fernandes HM, Mendelow AD, Choksey MS. Anterior cervical discectomy: An improvement in donor site operative technique. Br J Nenrosurg. 1994; 8: 201-20310.
10. Morgenstem LB, Frankowski RF, Shedden P, Pasteur W, Grotta JC. Surgical treatment for intracerebral hemorrhage (stich): A single-center, randomized clinical trial. Neurology. 1998; 51: 1359-1363
11. Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracerebral hemorrhage: Incidence and time course. Stroke. 1996; 27: 1783-1787
12. Xi G, Wagner KR, Keep RF, Hua Y, de Courten-Myers GM, Broderick JP, Brott TG, Heft JT, Muizelaar JP. Role of blood clot formation on early edema development after experimental intracerebral hemorrhage-editorial comment. Stroke. 1995; 29: 2550-2556
13. Kaneko M, Tanaka K, Shimada T, Sate K, Uemura K. Long-term evaluation of ultra-early operation for hypertensive intraccrebral hemorrhage in 100 cases. J Neurosurg. 1983; 58: 838-842
14. Yukawa H, Kanaya H. [indication for surgery in hypertensive intracerebral hemorrhage—a statistical study (author's transl)]. Neurol Med Chir (Tokyo). 1978; 18: 361-365
15. Zuccarello M, Brott T, Derex L, Kothari R, Sauerbeck L, Tew J, Van Loveren H, Yeh H-S, Tomsick T, Pancioli A, Khoury J, Broderick J. Early surgical treatment for supratentorial intracerebral hemorrhage: A randomized feasibility study. Stroke. 1999; 30:1 833-1839
16. Sate N, Nishimura K, Kanaya H, Yamaguehi K, Yukawa H. Followup results one year after surgery in patients with hypertensive intracerebral hemorrhage. Neurol Med Chir(Tokyo). 1976; 16: 109-114
17. Nakayama T, Date C, Yokoyama T, Yoshiike N, Yamaguchi M, Tanaka H. A 15.5-yea follow-up study of stroke in a japanese provincial city: The shibata study. Stroke. 1997; 28: 45-52
18. Kadojic D, Barac B, Trkanjec Z, Kadojic M. The secular trend in the incidence of hemorrhagic stroke in the region of osijek, eastern croatia in the period 1988-2000 a hospital based study. Coil Antropol. 2002; 26: 627-634
19. St Louis EK, Wijdicks EF, Li H, Atkinson JD. Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. Can J Neurol Sci. 2000; 27: 32-36
20. Razzaq AA, Hussain R. Determinants of 3G-day mortality of spontaneous intracerebral hemorrhage in pakistan. Surg Neurol. 1998; 50: 336-342; discussion 342-333
21. Lee KR, Kawai N, Kim S, Sagher O, Hoff JT. Mechanisms of edema formation after intracerebral hemorrhage: Effects of thrombin on cerebral blood flow, blood-brain barrier permeability, and cell survival in a rat model. J Neurosurg. 1997; 86: 272-278
22. Hemphill JC, Ⅲ, Bonovich DC, Besmertis L, Manley GT, Johnston SC, Tuhrim S. The ich score: A simple, reliable grading scale for intracerebral hemorrhage editorial comment: A simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001; 32: 891-897
23. Auer LM, Deinsberger W, Niederkom K, Gell G, Kleinert R, Schneider G, Holzer P, Bone G, Mokry M, Korner E, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: A randomized study. J Neurosurg. 1989; 70: 530-535
1. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001; 344: 1450-1460
2. Diringer MN. Intracerebral hemorrhage: Pathophysiology and management. Crit Care Med. 1993; 21: 1591-1603
3. Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993; 78: 188-191
4. Kanno T, Nagata J, Nonomura K, Asai T, Inoue T, Nakagawa T, Mitsuyama E New approaches in the treatment of hypertensive intracerebral hemorrhage. Stroke. 1993; 24: 196-100; discussion 1107-108
5. Kaya RA, Turkmenoglu O, Ziyal IM, Dalkilic T, Sahin Y, Aydin Y. The effects. on prognosis of surgical treatment of hypertensive putaminal hematomas through transsylvian transinsular approach. Surg Neurol. 2003; 59: 176-183; discussion 183
6. Liliang P-C, Liang C-L, Lu C-H, Chang H-W, Cheng C-H, Lee T-C, Chen H-J. Hypertensive caudate hemorrhage prognostic predictor, outcome, and role of external ventricular drainage. Stroke. 2001; 32: 1195-1200
7. McKissock W, Richardson A, Walsh L. Anterior commtmicating aneurysms: A trial of conservative and surgical treatment. Lancet. 1965; 34: 874-876
8. Fernandes HM, Gregson B, Siddique S, Mendelow AD. Surgery in intracerebral hemorrhage: The uncertainty continues. Stroke. 2000; 31: 2511-2516
9. Fernandes HM, Mendelow AD, Choksey MS. Anterior cervical discectomy: An improvement in donor site operative technique. Br J Neurosurg. 1994; 8: 201-20310.
10. Morgenstem LB, Frankowski RF, Shedden P, Pasteur W, Grotta JC. Surgical treatment for intracerebral hemorrhage (stich): A single-center, randomized clinical trial. Neurology. 1998; 51: 1359-1363
11. Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracarebral hemorrhage: Incidence and time course. Stroke. 1996; 27: 1783-1787
12. Xi G, Wagner KR, Keep RF, Hua Y, de Courten-Myers GM, Broderick JP, Brott TG, Hoff JT, Muizelaar JP. Role of blood clot formation on early edema development after experimental intracerebral hemorrhage. editorial comment. Stroke. 1998; 29: 2580-2586
13. Kaneko M, Tanaka K, Shimada T, Sato K, Uemura K. Long-term evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J Neurosurg. 1983; 58: 838-842
14. Yukawa H, Kanaya H. [indication for surgery in hypertensive intraeerebral hemorrhage-a statistical study (author's transl)]. Neurol Med Cbir (Tokyo). 1978; 18: 361-365
15. Zueearello M, Brott T, Derex L, Kothari R, Sauerbeek L, Tew J, Van Loveren H, Yeh H-S, Tomsiek T, Paneioli A, Khoury J, Broderiek J. Early surgical treatment for supratentorial intracerebral hemorrhage : A randomized feasibility study. Stroke. 1999; 30:1 833-1839
16. Sato N, Nishimura K, Kanaya H, Yamaguchi K, Yukawa H. Followup results one year after surgery in patients with hypertensive intracerebral hemorrhage. Neurol Med Chir(Tokyo). 1976; 16: 109-114
17. Nakayama T, Date C, Yokoyama T, Yoshiike N, Yamaguehi M, Tanaka H. A 15.5-yea follow-up study of stroke in a japanese provincial city: The shibata study. Stroke. 1997; 28: 45-52
18. Kadojic D, Barac B, Trkanjec Z, Kadojic M. The secular trend in the incidence of hemorrhagic stroke in the region of osijek, eastern croatia in the period 1988-2000 a hospital based study. Coil Antropol. 2002; 26: 627-634
19. St Louis EK, Wijdicks EF, Li H, Atkinson JD. Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. Can J Neurol Sci. 2000; 27: 32-36
20. Razzaq AA, Hussain R. Determinants of 30-day mortality of spontaneous intracerebral hemorrhage in pakistan. Surg Neurol. 1998; 50: 336-342; discussion 342-333
21. Lee KR, Kawai N, Kim S, Sagher O, Hoff JT. Mechanisms of edema formation after intracerebral hemorrhage: Effects of thrombin on cerebral blood flow, blood-brain barrier permeability, and cell survival in a rat model. J Neurosurg. 1997; 86: 272-278
22. Hemphill JC, HI, Bonovich DC, Besmertis L, Manley GT, Johnston SC, Tuhrim S. The ich score: A simple, reliable grading scale for intracerebral hemorrhage editorial comment: A simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001; 32: 891-897
23. Auer LM, Deinsberger W, Niederkorn K, Gell G, Kleinert R, Schneider G, Holzer P, Bone G, Mokry M, Komer E, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: A randomized study. J Neurosurg. 1989; 70: 530-535
1. Qureshi AI, Tuhfim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001; 344: 1450-1460
2. Diringer MN. Intracerebral hemorrhage: Pathophysiology and management. Crit Care Med. 1993; 21: 1591-1603
3. Kazui S, Nadtomi H, Yamamoto H, et al. Enlargement of spontaneous intracerebral hemorrhage, incidence and time course. Stroke. 1996, 27: 1783-1987
4. Xi GH, Wagner KR, Keep RF, et al. Role of blood clot formation on early edema development after experimental intracerebral hemorrhage. Stroke. 1998, 29(12): 2580-2586
5. Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993; 78: 188-191
6. Wang DJ, Wang S, Zhao YL, et al. Multianalysis of short-term prognostic factors in surgical practices for hypertensive intracerebral hemorrhage. Zhonghua Yi Xue Za Zhi. 2005. 85: 3118-3122
7. Nakayama T, Date C, Yokoyama T, et al. A 15.5-year follow-up study of stroke in a Japanese provincial city-The Shibata Study. Stroke. 1997, 28: 45-22
8. Kadojic D, Barac B, Trkanjec Z., et al. The secular trend in the incidence of hemorrhagic stroke in the region of Osijek, Eastern Croatia in the period 1988-2000—a hospital based study. Collegium Antropologicum. 2002. 26: 627-634
9. St Louis EK, Wijdicks EF, Li H, et ai. Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. Can J Neurol Sci. 2000; 27: 32-36
10. Razzaq AA, Hussain R. Determinants of 30-day mortality of spontaneous intracerebral hemorrhage in Pakistan. Surg Neurol. 1998; 50: 336-342
11. Hemphill Ⅲ JC, Bonovich DC, Besmertis L, et al. A simple, reliable grading scale for intracerebral hemorrhage. Stroke, 2001, 32: 891-897
12. LeeKR, Kawai N, Kim S, et al. Mechanisms of edema formation after intracerebral hemorrhage: effects of thrombin on CBF, BBB, permeability and cell survival in a rat model. J. Neurosurg. 1997, 86: 272-278
13. McKissock W, Richardson A, Taylor J. Primary intracerebral haemorrhage: a controlled trial of surgical and conservative treatment in 180 unselected cases. Lancet. 1961; 2: 221-226
14. Zuccarello M, Brott T, Derex L, et al. The treatment of spontaneous intracerebral hemorrhage: A prospective randomized trial of surgical and conservative treatment. J Neurosurg. 1999: 30: 1833-1839
15. Prasad K, Bowman G, Srivastava A, Menon G. Surgery in primary supratentorial intracerebral hematoma: a meta-analysis of randomized trials. Acta Neurol Scand. 1997; 95: 103-110.
16. Hankey GJ, Hon C. Surgery for primary intracerebral hemorrhage: is it safe and effective? A systematic review of case series and randomized trials. Stroke. 1997; 28: 2126-2132
17. Fernandes HM, Gregson B, Siddique S, et al. Surgery in intracerebral hemorrhage. The uncertainty continues. Stroke 2000, 31: 2511-2516
18. Sato N, Nishimura K, Kanaya H, Yamaguchi K, Yukawa H. Followup results one year after surgery in patients with hypertensive intracerebral hemorrhage. Neurol Med Chit(Tokyo). 1976; 16: 109-114
19. Morgenstem LB, Frankowski RF, Shedden P, et al. Surgical treatment for intracerebral hemorrhage (STICH): a single-center, randomized clinical trial. Neurology. 1998; 51: 1359-1363
20. Saver JL, Hankey G, Hon C. Surgery for primary intracerebral hemorrhage: meta-analysis of CT-era studies. Stroke. 1998; 29: 1477-1478
21. Fernandes H, Mendelow A. Spontaneous intracerebral hemorrhage: a surgical dilemma: Br J Neurosurg. 1999. 13: 389-394
22. Yukawa H, Kanaya H. Indication for surgery in hypertensive intracerebral hemorrhage-a statistical study. Neurol Med Chir(Tokyo) 1978. 18: 361-365
23. Cushing H. The blood-pressure reaction of acute cerebral compression, illustrated by cases of intracranial hemorrhage. Am J Med Sci 1903, 125: 1017-1044
24. Zuccarello M, Brott T, Derex L, et al. Early surgical treatment for supratentorial intracerebral hemorrhage: a randomized feasibility study. Stroke. 1999; 30: 1833-1839
25. Brott T, Broderick J, Kothari R, et al. Early hemorrhage in patients with intracerebral hemorrhage. Stroke. 1997, 28: 1-5
26. Kaneko M, Tanaka K, Shimada T, et al. Long-term evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J Neurosurg. 1983. 58: 838-842
27. Kaya RA, Turkmenoglu O, Ziyal IM. Dalkilic T, et al. The effects on prognosis of surgical treatment of hypertensive putaminal hematomas through transsylvian transinsular approach. Surgical Neurology. 2003. 59: 176-183
28. LiLiang PC, Liang CL, Lu CH, et al. Hypertensive caudate hemorrhage: Prognostic predictor, outcome, and role of external ventricular drainge. Stroke. 2001, 32: 1195-1200
29. Zhao JZ, Zhou DB, Zhou LF, et al. The efficacy of three different approaches in treatment of hypertensive intracerebral hemorrhage: a multi-center single-blind study of 2464 patients. Zhonghua Yi Xue Za Zhi. 2005. 85: 2238-2242
30. Kanno T, Nagata T, Nonomura K, et al. New approaches in the treatment of hypertensive intracerebral hemorrhage. Stroke, 1993, 24 (Suppl Ⅰ): Ⅰ-96-Ⅰ-100
31. Kim MA, Kim EY, Song JH, et al. Surgical options of hypertensive intracerebral hemorrhage: Stereotactic endoscopic removal versus stereotactic catheter drainage. J, Korean Med Sci., 1998: 533
32. Auer LM, Deinsberger W, Niederkorn K, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: A randomized study. J Neurosourg. 1989. 70: 530-535
33. Fernandes HM, Mendelow AD, Choksey MS. Anterior cervical discectomy: An improvement in donor site operative technique. Br J Neurosurg. 1994; 8: 201-203
34．胡多利，陈忠良，朱其铮．36例脑出血微创手术前后影像学变化及临床分析．中华临床医学杂志．2005；6：31-33
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37．彭远强，陈善固，曾胜田．高血压脑出血的手术治疗．中华神经医学杂志， 2005 4；6：622-623
38．张延平，张攀，李业生．高血压脑出血继发重型脑室内出血的微创手术治疗(附169例报告)．中国微侵袭神经外科杂志，2006；11：84-85
39．李树春，赵振华．微创手术治疗高血压脑出血临床分析．中国现代神经疾病杂志，2005；5：171
40．李金彩，李中秋，陆兵勋，等．脑立体定向微创手术治疗高血压脑出血．中华神经医学杂志，2006；5：855-856
2. Diringer MN. Intracerebral hemorrhage: Pathophysiology and management. Crit Care Med. 1993; 21: 1591-1603
3. Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993; 78: 188-191
4. Kanno T, Nagata J, Nonomura K, Asai T, Inoue T, Nakagawa T, Mitsuyama F. New approaches in the treatment of hypertensive intracerebral hemorrhage. Stroke. 1993; 24: 196-100; discussion 1107-108
5. Kaya RA, Turkmenoglu O, Ziyal IM, Dalkilic T, Sahin Y, Aydin Y. The effects on prognosis of surgical treatment of hyportensivc putaminal hematomas through transsylvian transinsular approach. Surg Ncurol. 2003; 59: 176-183; discussion 183
6. Liliang P-C, Liang C-L, Lu C-H, Chang H-W, Cheng C-H, Lee T-C, Chen H-J. Hypertensive caudate hemorrhage prognostic predictor, outcome, and role of external ventricular drainage. Stroke. 2001; 32: 1195-1200
7. McKissock W, Richardson A, Walsh L. Anterior communicating aneurysms: A trial of conservative and surgical treatment. Lancet. 1965; 34: 874-876
8. Fernandes HM, Gregson B, Siddique S, Mendelow AD. Surgery in intracerebral hemorrhage: The uncertainty continues. Stroke. 2000; 31: 2511-2516
9. Fernandes HM, Mendelow AD, Choksey MS. Anterior cervical discectomy: An improvement in donor site operative technique. Br J Nenrosurg. 1994; 8: 201-20310.
10. Morgenstem LB, Frankowski RF, Shedden P, Pasteur W, Grotta JC. Surgical treatment for intracerebral hemorrhage (stich): A single-center, randomized clinical trial. Neurology. 1998; 51: 1359-1363
11. Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracerebral hemorrhage: Incidence and time course. Stroke. 1996; 27: 1783-1787
12. Xi G, Wagner KR, Keep RF, Hua Y, de Courten-Myers GM, Broderick JP, Brott TG, Heft JT, Muizelaar JP. Role of blood clot formation on early edema development after experimental intracerebral hemorrhage-editorial comment. Stroke. 1995; 29: 2550-2556
13. Kaneko M, Tanaka K, Shimada T, Sate K, Uemura K. Long-term evaluation of ultra-early operation for hypertensive intraccrebral hemorrhage in 100 cases. J Neurosurg. 1983; 58: 838-842
14. Yukawa H, Kanaya H. [indication for surgery in hypertensive intracerebral hemorrhage—a statistical study (author's transl)]. Neurol Med Chir (Tokyo). 1978; 18: 361-365
15. Zuccarello M, Brott T, Derex L, Kothari R, Sauerbeck L, Tew J, Van Loveren H, Yeh H-S, Tomsick T, Pancioli A, Khoury J, Broderick J. Early surgical treatment for supratentorial intracerebral hemorrhage: A randomized feasibility study. Stroke. 1999; 30:1 833-1839
16. Sate N, Nishimura K, Kanaya H, Yamaguehi K, Yukawa H. Followup results one year after surgery in patients with hypertensive intracerebral hemorrhage. Neurol Med Chir(Tokyo). 1976; 16: 109-114
17. Nakayama T, Date C, Yokoyama T, Yoshiike N, Yamaguchi M, Tanaka H. A 15.5-yea follow-up study of stroke in a japanese provincial city: The shibata study. Stroke. 1997; 28: 45-52
18. Kadojic D, Barac B, Trkanjec Z, Kadojic M. The secular trend in the incidence of hemorrhagic stroke in the region of osijek, eastern croatia in the period 1988-2000 a hospital based study. Coil Antropol. 2002; 26: 627-634
19. St Louis EK, Wijdicks EF, Li H, Atkinson JD. Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. Can J Neurol Sci. 2000; 27: 32-36
20. Razzaq AA, Hussain R. Determinants of 3G-day mortality of spontaneous intracerebral hemorrhage in pakistan. Surg Neurol. 1998; 50: 336-342; discussion 342-333
21. Lee KR, Kawai N, Kim S, Sagher O, Hoff JT. Mechanisms of edema formation after intracerebral hemorrhage: Effects of thrombin on cerebral blood flow, blood-brain barrier permeability, and cell survival in a rat model. J Neurosurg. 1997; 86: 272-278
22. Hemphill JC, Ⅲ, Bonovich DC, Besmertis L, Manley GT, Johnston SC, Tuhrim S. The ich score: A simple, reliable grading scale for intracerebral hemorrhage editorial comment: A simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001; 32: 891-897
23. Auer LM, Deinsberger W, Niederkom K, Gell G, Kleinert R, Schneider G, Holzer P, Bone G, Mokry M, Korner E, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: A randomized study. J Neurosurg. 1989; 70: 530-535
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11. Hemphill Ⅲ JC, Bonovich DC, Besmertis L, et al. A simple, reliable grading scale for intracerebral hemorrhage. Stroke, 2001, 32: 891-897
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27. Kaya RA, Turkmenoglu O, Ziyal IM. Dalkilic T, et al. The effects on prognosis of surgical treatment of hypertensive putaminal hematomas through transsylvian transinsular approach. Surgical Neurology. 2003. 59: 176-183
28. LiLiang PC, Liang CL, Lu CH, et al. Hypertensive caudate hemorrhage: Prognostic predictor, outcome, and role of external ventricular drainge. Stroke. 2001, 32: 1195-1200
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30. Kanno T, Nagata T, Nonomura K, et al. New approaches in the treatment of hypertensive intracerebral hemorrhage. Stroke, 1993, 24 (Suppl Ⅰ): Ⅰ-96-Ⅰ-100
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33. Fernandes HM, Mendelow AD, Choksey MS. Anterior cervical discectomy: An improvement in donor site operative technique. Br J Neurosurg. 1994; 8: 201-203
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