Thalamic hypertensive hemorrhage

: We performed statistic analysis of the results of both conservative and surgical (by means of laying on the external ventricle drain--EVD) treatment of 23 patients with thalamic (medial) hypertensive hemorrhage (THH) admitted to the hospital in the first two days of the stroke's beginning. We also investigated clinical tomographic factors which had influence either on the choice of the treatment or on the prognosis of the disease. The frequency of the lethal cases in EVD-group (6 observations) was about twice lower than in analogous group of patients treated conservatively (17 cases). In conservative treatment prognostically unfavourable factors in acute period of the stroke were the following: the awakening level lower than 10 points according to Glasgow Scale, development of acute obstructive hydrocephalus, dislocation of brain stem, break of blood into cerebral ventricles (of II-IV degree), the volume of hemorrhage more than 10 ml for thalamic and thalamo-capsular location and more than 5 ml for thalamo-mesencephalic location. Monitoring of intracranial pressure in patients with THH which had factors mentioned above revealed the development of steadfast intracranial hypertension by days 5-7 maximally. The laying on EVD was indicated in patients with unfavourable signs of THH by means of ventricle drainage. The controlled decrease of intracranial pressure increased the level of awakening, meanwhile it decreased the degree of hydrochephalus and dislocation of brain stem.