THALAMIC HYPERTENSIVE HEMORRHAGE

We performed statistic analysis of the results of both conservative an d surgical (by means of laying on the external ventricle drain - EVD) treatment of 23 patients with thalamic (medial) hypertensive hemorrhag e (THH) admitted to the hospital in the first two days of the stroke's beginning, We also investigated clinical tomographic factors which ha d influence either on the choice of the treatment or on the prognosis of the disease. The frequency of the lethal cases in EVD-group (6 obse rvations) was about twice lower than in analogous group of patients tr eated conservatively (17 cases). In conservative treatment prognostica lly unfavourable factors in acute period of the stroke were the follow ing: the awakening level lower than 10 points according to Glasgow Sca le, development of acute obstructive hydrocephalus, dislocation of bra in stem, break of blood into cerebral ventricles (of II-IV degree), th e volume of hemorrhage more than 10 ml for thalamic and thalamo-capsul ar location and more than 5 ml for thalamomesencephalic location. Moni toring of intracranial pressure in patients with THH which had factors mentioned above revealed the development of steadfast intracranial hy pertension by days 5-7 maximally. The laying on EVD was indicated in p atients with unfavourable signs of THH by means of ventricle drainage. The controlled decrease of intracranial pressure increased the level of awakening, meanwhile it decreased the degree of hydrochephalus and dislocation of brain stem.