Surgical or Conservative Treatment and Mortality in Patients with Deep Spontaneous Intracerebral Hematoma

Abstract

Introduction: Evacuation of spontaneous intracerebral hematoma is part of its treatment. Postoperative mortality is high in deep hematomas and sometimes higher than when conservative treatment is performed.

Objective: To compare the hospital mortality of patients with deep spontaneous intracerebral hematoma without hydrocephalus, in relation to surgical or conservative treatment.

Methods: This is an analytical study carried out at General Calixto García University Hospital, from January 2016 to December 2019, in patients diagnosed with deep spontaneous intracerebral hematoma without hydrocephalus, 32 operated by craniotomy and evacuation of the hematoma and 30 treated conservatively that resulted from random age matching, data were obtained from medical records. The t-student test, Fisher's exact statistic and odd ratio were used.

Results: Mortality was related to older age in both groups (p= 0.032 in the surgical group and p= 0.021 in the conservative group), as well as the Glasgow Coma Scale ≤ 8 points (p= 0.001 in the surgical group and p= 0.008 in the conservative group); mortality was 84.4% in the surgical procedure and 63.3% in the conservative procedure. This difference was significant (p= 0.045).

Conclusions: In patients with deep spontaneous intracerebral hematoma without hydrocephalus, higher mortality is associated with older age and values on the Glasgow scale for coma ≤ 8 points, both factors of poor prognosis. In turn, in those treated by craniotomy and evacuation of the hematoma, there are more deaths than in those treated conservatively.