Sonography assisted clot evacuation in early intracerebral haemorrhage
Spontaneous intracerebral haemorrhages (ICH) are an increasingly common condition that leads to severe morbidities and mortality. Early surgical evacuation of spontaneous supratentorial ICHs has not consistently been proven to be beneficial from multiple studies. We investigate the effectiveness...
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| Format: | Thesis |
| Language: | English |
| Published: |
2020
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| Online Access: | http://eprints.usm.my/56941/1/TEO%20EU%20GENE%20-%20e%2024.pdf |
| _version_ | 1825907594196156416 |
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| author | Gene, Teo Eu |
| author_facet | Gene, Teo Eu |
| author_sort | Gene, Teo Eu |
| collection | USM |
| description | Spontaneous intracerebral haemorrhages (ICH) are an increasingly common condition
that leads to severe morbidities and mortality. Early surgical evacuation of spontaneous
supratentorial ICHs has not consistently been proven to be beneficial from multiple
studies. We investigate the effectiveness of ultrasound guided early surgical evacuation
of spontaneous supratentorial ICHs with respect to the completeness of evacuation on
radiological evaluation. We prospectively recruited 58 patients who presented to a tertiary Neurosurgery centre
in Malaysia within 48 hours of ictus for a spontaneous supratentorial ICH and underwent
surgical evacuation of clot between June 2017 to February 2019. The patients were
randomly assigned to surgical evacuation of clot with or without intraoperative ultrasound
guidance in 1:1 ratio. Pre operative and immediate post operative CT brain images were
compared. The primary outcome was the completeness of clot evacuation measured via
the (a x b x c)/2 formula. The patient or their family underwent a telephone interview 3
months post surgery to assess neurological outcome. 29 patients were randomly assigned to both early surgical evacuation of clot with and
without intraoperative ultrasound guidance. All patients were followed up at 3 months.
Patients in the surgical evacuation with intraoperative ultrasound guidance and without
intraoperative ultrasound guidance had mean reductions of 88.7% and 86.9%
respectively, which was statistically significant, p value = 0.022. Mortality rate at 3 months for both groups was 10.3% and 20.1% respectively. (OR 2.3, 95% CI 0.51 to
10.08; p = 0.285).
Conclusion Ultrasound guided evacuation of spontaneous supratentorial ICHs increases the
completeness of clot evacuation via radiological evaluation. |
| first_indexed | 2024-03-06T16:06:31Z |
| format | Thesis |
| id | usm.eprints-56941 |
| institution | Universiti Sains Malaysia |
| language | English |
| last_indexed | 2024-03-06T16:06:31Z |
| publishDate | 2020 |
| record_format | dspace |
| spelling | usm.eprints-569412023-02-14T08:57:49Z http://eprints.usm.my/56941/ Sonography assisted clot evacuation in early intracerebral haemorrhage Gene, Teo Eu R Medicine (General) Spontaneous intracerebral haemorrhages (ICH) are an increasingly common condition that leads to severe morbidities and mortality. Early surgical evacuation of spontaneous supratentorial ICHs has not consistently been proven to be beneficial from multiple studies. We investigate the effectiveness of ultrasound guided early surgical evacuation of spontaneous supratentorial ICHs with respect to the completeness of evacuation on radiological evaluation. We prospectively recruited 58 patients who presented to a tertiary Neurosurgery centre in Malaysia within 48 hours of ictus for a spontaneous supratentorial ICH and underwent surgical evacuation of clot between June 2017 to February 2019. The patients were randomly assigned to surgical evacuation of clot with or without intraoperative ultrasound guidance in 1:1 ratio. Pre operative and immediate post operative CT brain images were compared. The primary outcome was the completeness of clot evacuation measured via the (a x b x c)/2 formula. The patient or their family underwent a telephone interview 3 months post surgery to assess neurological outcome. 29 patients were randomly assigned to both early surgical evacuation of clot with and without intraoperative ultrasound guidance. All patients were followed up at 3 months. Patients in the surgical evacuation with intraoperative ultrasound guidance and without intraoperative ultrasound guidance had mean reductions of 88.7% and 86.9% respectively, which was statistically significant, p value = 0.022. Mortality rate at 3 months for both groups was 10.3% and 20.1% respectively. (OR 2.3, 95% CI 0.51 to 10.08; p = 0.285). Conclusion Ultrasound guided evacuation of spontaneous supratentorial ICHs increases the completeness of clot evacuation via radiological evaluation. 2020 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/56941/1/TEO%20EU%20GENE%20-%20e%2024.pdf Gene, Teo Eu (2020) Sonography assisted clot evacuation in early intracerebral haemorrhage. Masters thesis, Universiti Sains Malaysia. |
| spellingShingle | R Medicine (General) Gene, Teo Eu Sonography assisted clot evacuation in early intracerebral haemorrhage |
| title | Sonography assisted clot evacuation in
early intracerebral haemorrhage |
| title_full | Sonography assisted clot evacuation in
early intracerebral haemorrhage |
| title_fullStr | Sonography assisted clot evacuation in
early intracerebral haemorrhage |
| title_full_unstemmed | Sonography assisted clot evacuation in
early intracerebral haemorrhage |
| title_short | Sonography assisted clot evacuation in
early intracerebral haemorrhage |
| title_sort | sonography assisted clot evacuation in early intracerebral haemorrhage |
| topic | R Medicine (General) |
| url | http://eprints.usm.my/56941/1/TEO%20EU%20GENE%20-%20e%2024.pdf |
| work_keys_str_mv | AT geneteoeu sonographyassistedclotevacuationinearlyintracerebralhaemorrhage |