Manual stereotactic aspiration of spontaneous deep-seated intracerebral haematomas in non-comatose patients.

Manual stereotactic aspiration was used in 46 consecutive non-comatose patients with haematomas within the basal ganglia and the results were compared with those obtained in a similar group of 39 patients who were treated purely medically in another hospital. The operation was performed in the subacute stage, and in most cases three target-points were chosen on the scan with the largest expansion of the haematoma. The haematoma was manually aspirated with a syringe device in different depths in regard to the target-points, and mean proportion aspirated was 90.2%. The level of consciousness improved markedly and GCS scores after stereotactic surgery were significantly higher than those after medical treatment (p < 0.0001). Peri-ictal mortality was significantly reduced in the surgical group and with improved levels of consciousness, the patients were suitable for further rehabilitative treatment earlier. This resulted in a significantly reduced in-patient stay. Manual stereotactic aspiration of deep-seated intracerebral haematomas in the subacute stage proved to be a simple and safe method with high efficacy.