Failure of surgery to improve outcome in hypertensive putaminal hemorrhage. A prospective randomized trial

H. H. Batjer, J. S. Reisch, B. C. Allen, L. J. Plaizier, C. Jen Su

Research output: Contribution to journalArticle

238 Citations (Scopus)

Abstract

Hypertensive putaminal hemorrhage remains a major cause of hemorrhagic stroke carrying extremely high morbidity. Considerable controversy remains regarding the optimal form of therapy. Between 1983 and 1989 we conducted a prospective randomized trial with three treatment strategies: best medical management, best medical management plus intracranial pressure monitoring, and surgical evacuation. Only patients with significant deficit harboring a putaminal hematoma at least 3.0 cm in diameter were entered. The study was interrupted after 21 patients had been studied (9, best medical management; 4, intracranial pressure monitoring; and 8, surgical evacuation). No differences were found among groups for age, admission blood pressure, and time interval between onset of symptoms and arrival at hospital. None of the subjects were capable of returning to prestroke activity. Fifteen (71%) died or remained vegetative at 6 months, and only 4 (19%) were capable of independent life at home. Of the 9 patients in the best medical management arm, 7 were dead or vegetative. In the surgical group, 4 patients died and only 2 were capable of independent life. These results suggest that current medical and neurosurgical therapies remain ineffective in preventing the devastating neurologic consequences of hypertensive putaminal hemorrhage.

Original languageEnglish (US)
Pages (from-to)1103-1106
Number of pages4
JournalArchives of Neurology
Volume47
Issue number10
StatePublished - 1990

Fingerprint

Putaminal Hemorrhage
Intracranial Pressure
Nervous System
Therapeutics
Age Groups
Stroke
Blood Pressure
Morbidity
Surgery

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Failure of surgery to improve outcome in hypertensive putaminal hemorrhage. A prospective randomized trial. / Batjer, H. H.; Reisch, J. S.; Allen, B. C.; Plaizier, L. J.; Jen Su, C.

In: Archives of Neurology, Vol. 47, No. 10, 1990, p. 1103-1106.

Research output: Contribution to journalArticle

@article{3262b826b99d45a7b2d6f98df1f7bb03,
title = "Failure of surgery to improve outcome in hypertensive putaminal hemorrhage. A prospective randomized trial",
abstract = "Hypertensive putaminal hemorrhage remains a major cause of hemorrhagic stroke carrying extremely high morbidity. Considerable controversy remains regarding the optimal form of therapy. Between 1983 and 1989 we conducted a prospective randomized trial with three treatment strategies: best medical management, best medical management plus intracranial pressure monitoring, and surgical evacuation. Only patients with significant deficit harboring a putaminal hematoma at least 3.0 cm in diameter were entered. The study was interrupted after 21 patients had been studied (9, best medical management; 4, intracranial pressure monitoring; and 8, surgical evacuation). No differences were found among groups for age, admission blood pressure, and time interval between onset of symptoms and arrival at hospital. None of the subjects were capable of returning to prestroke activity. Fifteen (71{\%}) died or remained vegetative at 6 months, and only 4 (19{\%}) were capable of independent life at home. Of the 9 patients in the best medical management arm, 7 were dead or vegetative. In the surgical group, 4 patients died and only 2 were capable of independent life. These results suggest that current medical and neurosurgical therapies remain ineffective in preventing the devastating neurologic consequences of hypertensive putaminal hemorrhage.",
author = "Batjer, {H. H.} and Reisch, {J. S.} and Allen, {B. C.} and Plaizier, {L. J.} and {Jen Su}, C.",
year = "1990",
language = "English (US)",
volume = "47",
pages = "1103--1106",
journal = "Archives of Neurology",
issn = "0003-9942",
publisher = "American Medical Association",
number = "10",

}

TY - JOUR

T1 - Failure of surgery to improve outcome in hypertensive putaminal hemorrhage. A prospective randomized trial

AU - Batjer, H. H.

AU - Reisch, J. S.

AU - Allen, B. C.

AU - Plaizier, L. J.

AU - Jen Su, C.

PY - 1990

Y1 - 1990

N2 - Hypertensive putaminal hemorrhage remains a major cause of hemorrhagic stroke carrying extremely high morbidity. Considerable controversy remains regarding the optimal form of therapy. Between 1983 and 1989 we conducted a prospective randomized trial with three treatment strategies: best medical management, best medical management plus intracranial pressure monitoring, and surgical evacuation. Only patients with significant deficit harboring a putaminal hematoma at least 3.0 cm in diameter were entered. The study was interrupted after 21 patients had been studied (9, best medical management; 4, intracranial pressure monitoring; and 8, surgical evacuation). No differences were found among groups for age, admission blood pressure, and time interval between onset of symptoms and arrival at hospital. None of the subjects were capable of returning to prestroke activity. Fifteen (71%) died or remained vegetative at 6 months, and only 4 (19%) were capable of independent life at home. Of the 9 patients in the best medical management arm, 7 were dead or vegetative. In the surgical group, 4 patients died and only 2 were capable of independent life. These results suggest that current medical and neurosurgical therapies remain ineffective in preventing the devastating neurologic consequences of hypertensive putaminal hemorrhage.

AB - Hypertensive putaminal hemorrhage remains a major cause of hemorrhagic stroke carrying extremely high morbidity. Considerable controversy remains regarding the optimal form of therapy. Between 1983 and 1989 we conducted a prospective randomized trial with three treatment strategies: best medical management, best medical management plus intracranial pressure monitoring, and surgical evacuation. Only patients with significant deficit harboring a putaminal hematoma at least 3.0 cm in diameter were entered. The study was interrupted after 21 patients had been studied (9, best medical management; 4, intracranial pressure monitoring; and 8, surgical evacuation). No differences were found among groups for age, admission blood pressure, and time interval between onset of symptoms and arrival at hospital. None of the subjects were capable of returning to prestroke activity. Fifteen (71%) died or remained vegetative at 6 months, and only 4 (19%) were capable of independent life at home. Of the 9 patients in the best medical management arm, 7 were dead or vegetative. In the surgical group, 4 patients died and only 2 were capable of independent life. These results suggest that current medical and neurosurgical therapies remain ineffective in preventing the devastating neurologic consequences of hypertensive putaminal hemorrhage.

UR - http://www.scopus.com/inward/record.url?scp=0025132306&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025132306&partnerID=8YFLogxK

M3 - Article

C2 - 2222242

AN - SCOPUS:0025132306

VL - 47

SP - 1103

EP - 1106

JO - Archives of Neurology

JF - Archives of Neurology

SN - 0003-9942

IS - 10

ER -