MANAGEMENT OF PRIMARY INTRACEREBRAL HEMATOMAS

112 cases of primary intracerebral hematomas treated surgically, 25 ca ses aspirated with urokinase infusion and 25 cases treated conservativ ely in the last five years were reviewed in detail. In the craniotomy group, 17 out of 44 survivors showed good recovery and returned to nor mal life, 18 of them went home needing no care, 8 went home needing pa rtial care, and one was bedridden. The overall mortality rate in this group was 59.8%. In the urokinase group, 6 out of 21 survivors showed good recovery and returned to normal life, 11 of them went home needin g no care, 3 went home needing partial care and one was bedridden. The overall mortality rate in this group was 16%. In the conservative gro up, 8 out of 19 survivors showed good recovery and returned to normal life, 9 of them went home needing no care, and two went home needing p artial care. The overall mortality rate in this group was 24%. Althoug h the mortality race was lower in the urokinase group compared with th e conservative group, there was no statistically significant differenc e between the two groups (P > 0.05). These results indicate that surge ry is useless in deeply comatose patients and CT-guided aspiration wit h urokinase is a simple, effective, and safe method in appropriately s elected patients.