Surgery's Role In Spontaneous Intracerebral Hematoma Management

Spontaneous Intracerebral Hematomas account for 10% of strokes, with a peak frequency  around 60. High blood pressure is the primary cause. Literature shows poor prognostic factors  and effective surgery for these hematomas.  The study reveals 13 Spontaneous Intracerebral Hematoma cases, operated at Mustapha  Pacha University Hospital (2019–2023) and ALI AIT IDIR Hospital Health Establishment  (2016–2019). High blood pressure is the primary cause, but hematomas complicating head  trauma, brain tumors, or vascular malformations are excluded from the study. The average  age of the patients was 63 years, with 9 men (69,23%%), and 4 women (30,76 %). Arterial  hypertension was the major cause, regardless of the hematoma's location. Amyloid  angiopathy is common at the age of 65. There is no obvious etiology, despite advances in  diagnostic possibilities. Clinical symptomatology may present with two modes of onset:  brutal (62.5%) and progressive (37%). A primarily cortical location is rare in hypertensive  patients, and they must systematically look for a vascular cause with imaging.  The series focuses on surgical treatment for lobar hematomas and central ganglia, with a  mortality rate of 62.5%. Patients were operated on late and in a comatose state, with a 30-day  mortality rate ranging from 35 to 52%. Neurosurgery involves regulating blood pressure,  stopping anticoagulant medication, and determining the necessity of surgery. Surgery,  including conventional craniotomy, minimally invasive surgery, and decompressive  craniectomy, has a contentious role in treating supratentorial hemorrhagic stroke.  

Key words hemorrhagic stroke, Spontaneous Intracerebral Hematomas, surgery