BACKGROUND:Continuous hemorrhage or hematoma enlargement often occurs following cerebral hemorrhage attacks. OBJECTIVE: To retrospectively analyze the influential factors for hematoma enlargement in patients with hypertensive cerebral hemorrhage prior to minimally invasive surgery. DESIGN, TIME AND SETTING: A comparative analysis of 90 patients with cerebral hemorrhage undergoing minimally invasive surgery at the Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between April 2005 and February 2007. PARTICIPANTS: Fifty-eight males and thirty-one females aged (52.7 ± 5.23) years (range, 28-73 years). METHODS: Cranial CT was performed twice to objectively identify hematoma enlargement. Patients with hematoma enlargement prior to surgery were selected as the observation group (n = 30), and those with no obvious hematoma changes served as the control group (n = 60). Following cranial CT localization, the two groups underwent minimally invasive hematoma aspiration and drainage, according to Standardized Treatment Guidelines for Micro-invasive Aspiration and Drainage of Intracranial Hematoma. MAIN OUTCOME MEASURES: Hemorrhage site, coagulation function, diabetes history, and clinical symptoms. RESULTS: There were no significant differences in hemorrhage sites between the two groups (χ2 = 2.262, P > 0.05). The percent of intemperance patients in the observation group was significantly larger than the control group (χ2 = 6.923, P 0.05). The percent of patients with clinical deterioration was significantly higher in the observation group, compared to the control group (χ2 = 25.57, P < 0.01). CONCLUSION: Intemperance and preoperative clinical deterioration may increase incidence of hematoma enlargement prior to minimally invasive surgery in patients with hypertensive cerebral hemorrhage.
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