Stereotactic Evacuation of Hypertensive Intracerebral Hematoma Using Plasminogen Activator

Surgical Technique and Long-Term Results
  • Toru Itakura
  • Norihiko Komai
  • Ekini Nakai
  • Eiji Doi


Treatment of hypertensive intracerebral hemorrhage has generally been carried out using either surgical evacuation by craniotomy or by conservative therapy. In 1974, Komai et al. [9] demonstrated for the first time that intracerebral hematoma can be safely evacuated by stereotactic technique, and suggested that stereotactic evacuation may become an applicable surgical procedure for hypertensive intracerebral hematoma. In 1980, we reported, for the first time, an extensive series of intracerebral hematomas treated by stereotactic evacuation using a plasminogen activator [1]. This new surgical procedure has since been acknowledged by other authors to be a safe and valuable treatment method for hypertensive intracerebral hematoma [7]. Since 1978, we have treated 241 intracerebral hematomas using the stereotactic approach. We herein report an analysis of our series and offer discussion on several controversial points in the surgical treatment of this disease.


Hematoma Volume Intracerebral Hematoma Head Frame Thalamic Hemorrhage Aspiration Rate 
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  1. 1.
    Doi E, Moriwaki H, Komai N (1980) Stereotactic operation for hypertensive intracerebral hemorrhage, especially for thalamic hemorrhage. Neurol Med Chir 20 (Suppl): 124–125 (abstract)Google Scholar
  2. 2.
    Kanaya H, Saiki I, Ohuchi T, Kamata K, Endo H, Mizukami M, Kagawa M, Kaneko M, Ito Z (1983) Hypertensive intracerebral hemorrhage in Japan: Update on surgical treatment. In: Mizukami M, Kanaya H, Kogure K, Yamori Y (eds) Hypertensive intracerebral hemorrhage. Raven, New York, pp 147–163Google Scholar
  3. 3.
    Kaneko M (1983) Timing of surgery for hypertensive intracerebral hemorrhage. In: Mizukami M, Kanaya H, Kogure K, Yamori Y (eds) Hypertensive intracerebral hemorrhage. Raven, New York, pp 249–253Google Scholar
  4. 4.
    Komai N (1984) CT-guided stereotactic operation. Nihon Rinsho 42:954–974Google Scholar
  5. 5.
    Komai N (1986) CT-stereotaxy. No Shinkei Geka 14:123–133PubMedGoogle Scholar
  6. 6.
    Komai N, Doi E, Moriwaki H, Nakai E (1986) Stereotactic evacuation of hypertensive thalamic hematoma using plasminogen activator (urokinase). No shinkei Geka 14:249–256PubMedGoogle Scholar
  7. 7.
    Matsumoto K, Hondo H (1984) CT-guided stereotactic evacuation of hypertensive intracerebral hematomas. J Neurosurg 61:440–448PubMedCrossRefGoogle Scholar
  8. 8.
    Narayan K, Narayan M, Katz A, Kobnblith L, Murano G (1985) Lysis of intracranial hematomas with urokinase in a rabbit model. J Neurosurg 62:580–586PubMedCrossRefGoogle Scholar
  9. 9.
    Shimamoto Y, Komai N, Nishina H, Kido T, Hamada T, Yabushita R, Kobayashi R, Taketsuna S, Koshimichi S (1974) Stereotactic removal of space-occupying lesions in the brain. J Wakayama Med Soc 25:391Google Scholar

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Toru Itakura
    • 1
  • Norihiko Komai
    • 1
  • Ekini Nakai
    • 1
  • Eiji Doi
    • 1
  1. 1.Department of Neurological SurgeryWakayama Medical CollegeWakayamaJapan

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