[CT-controlled stereotactic operations for hypertensive intracerebral hemorrhage Part 2: Cases with small hematomas in the thalamus and the basal ganglia].

Theoretical principles and actual operative procedures of "CT-controlled stereotactic operations," which was invented by us, have been reported in the previous paper of part 1. In this paper, it is reported 9 cases, 5 of putaminal hemorrhage and 4 of thalamic hemorrhage, who underwent CT-controlled stereotactic operations for evacuation of their small hematomas. Eight patients were male and one patient was female. The age of patients ranged from 42 to 75 years, with a mean age of 62.7 years and there were 3 patients of over 70 years old. And there were 2 patients with poor general condition preoperatively; one had the implantation of pacemaker because of Adams-Stokes syndrome 5 years ago and the other had total gastrectomy because of gastric neoplasm 1 month ago. Eight cases were in acute stage within three days after the onset. Mean operative timing was 14.6 hrs. after the onset. It was very interesting that three cases, 2 of putaminal and 1 of thalamic hemorrhage, had recovered dramatically by this surgery, just like the course after the hematoma evacuation in cases of chronic subdural hematoma. Namely their hemiparesis are decreased remarkably within a few hours after hematoma evacuation. Practically this surgery has minimum risk with simple procedures. The hematoma evacuation can be done easily with high accuracy of stereotaxy. From our experience, potential usefulness of this surgery was positively suggested in the surgical treatment for small ganglionic hematomas as well as thalamic hematomas.