ผลการรักษาโรคเส้นเลือดในสมองแตกเฉียบพลัน ด้วยการผ่าตัดใหญ่ในโรงพยาบาลศูนย์นครปฐม

บทคัดย่อ

       Intracranial or lntracerebral hemorrhage remain a significant emergency that is not less important than any Neurosurgical problems such as severe head injury or gunshot impact. A retrospective study for the result of surgical management of lntracerebral hemorrhage in Nakhonpathom hospital has been studied from 1 October, 2003 to 30 September, 2006. Severity classification of Intracerebral hemorrhage by World Federation of Neurological surgeons scale has been used in study. Results were 32% in grade 1, 34% in grade 2, 15% in grade 3, 10% in grade 4 and 9% in grade 5. Patients grade 3, 4, 5 were chosen to study because the size and site of lntracerebral clot have affected to depressed and damaged brainstem. Two groups of surgery were classified by method of removal of clot. Glasgow outcome scale was used to measure functional outcome. Results were moderate disability 30% Severe disabirity, Persistent vegetative state 17% and dead 22%. Level of consciousness and method of surgery were found to be the most important factor to determine surgical outcome. Mortality rate of severe patient grade 4 and 5 were statistically significant more than grade 3. Also surgical method that subtotal removal of clot about 1/2 to 2/3 had more survival rate than another one that nearly removal of clot by significance.