Management of spontaneous intra parenchymal hematomas: a cohort study


  • Girish K. Madhavan Department of Neurosurgery, GMC, Kottayam, Kerala, India
  • Philip Issac Department of Neurosurgery, GMC, Kottayam, Kerala, India
  • Balakrishnan P. Kunjan Department of Neurosurgery, GMC, Kottayam, Kerala, India
  • Ajax John Department of Neurosurgery, GMC, Kottayam, Kerala, India
  • Tom Jose Department of Neurosurgery, GMC, Kottayam, Kerala, India



Decompressive craniectomy, Intraparenchymal hemtoma, Hematoma evacuation


Background: Management of intra parenchymal hematoma is a dilemma for neuroscientists, still a life-threatening entity which needs multidisciplinary approach.13% of all strokes constitutes hemorrhagic. Mortality and morbidity of patients depends on the status of initial presentation. Prognosis of the surgeries may vary from person to person and according to the comorbidities. The aim of the study was to determine effectiveness of decompressive craniectomy (DC) with hematoma evacuation in reducing the mortality.

Methods: Patients with spontaneous intra parenchymal hematomas were selected and those having herniation syndrome were considered for surgery. Patients were evaluated after 30 days and 6 months and mortality was calculated.

Results: 126 patients were selected for surgery, in that 102 patients underwent DC with hematoma evacuation and 24 patients who were not willing for surgery were considered as control group. Mortality of patients at 30 days of surgical group was 19.6% and 58.3% respectively, while 6 months mortality was 31.3% and 70.8% for surgical and control group.

Conclusions: Surgical intervention can effectively reduce the mortality in spontaneous intra parenchymal hematomas.

Author Biographies

Girish K. Madhavan, Department of Neurosurgery, GMC, Kottayam, Kerala, India

Department  of neurosurgery

associate professor

Philip Issac, Department of Neurosurgery, GMC, Kottayam, Kerala, India

assistant professor

Balakrishnan P. Kunjan, Department of Neurosurgery, GMC, Kottayam, Kerala, India

professor, dept of neurosurgery

Ajax John, Department of Neurosurgery, GMC, Kottayam, Kerala, India

senior resident dept of neurosurgery

Tom Jose, Department of Neurosurgery, GMC, Kottayam, Kerala, India

Senior resident


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Original Research Articles