IJMABHR International Journal of Medical and All Body Health ResearchIJMABHR 2582-8940 Anfo Publication House 38 Hypertensive supratentorial intracerebral hemorrhage: Surgery or conservative management? HimanshuRaval ShahKalpesh Department of Neurosurgery, NHL Municipal Medical College, SVP Hospital Campus, Elisbridge, Ahmedabad, Gujarat, India Professor, Department of Neurosurgery, NHLMMC and SVP Hospital, Ahmedabad, Gujarat, India 2020 1 3 01 04 25062020 13072020 CC BY-NC-SA 4.0

Background: Spontaneous intra cerebral hemorrhage is defined as bleeding in brain parenchyma which is lethal at times. Various factor affect the outcome of patient with intra cerebral hemorrhage. rnObjective: Aim of this study is to study the clinical outcome of hypertensive supratentorial intra cerebral hemorrhage and influence of medical and surgical management and to compare the results with literature and assess the volume and location of the hemorrhagic lesion and to correlate with clinical picture and prognosis.rnMethod and materials: The present study conducted at VS hospital, SVP Hospital and NHL Municipal Medical College during the period from December 2018 to December 2020. 100 patients with intra cerebral hemorrhage diagnosed by clinical examination and CT scan and included.rnResult: The maximum incidence of patients was found in age group between 40 and 70 years, with Male preponderance. 50% were treated with medical management while 50% were treated with surgical management. Morbidity and mortality were higher in patients with low values of GCS and large volume of hemorrhage.rnConclusion: Patients with higher GCS and low volume of hemorrhage at time of presentation are benefited by medical treatment while patients with low GCS and larger hemorrhage with signs of raised ICT are benefited by surgical management.

 SICHIntra cerebral haemorrhagehypertensionsupratentorial References Howard Kaufman. Spontaneous Intraparenchymal Hemorrhages. In Wilkins, Setti Rengachary, Editors. Neurosurgery, 2 nd edition. Newyork: McGraw Hill, 1996, 2567-85. AN Jha. Spontaneous intracerebral haemorrhage. In B.Rammurthi, PN Tondon, Editors. Text Book of Neurosurgery, 3 rd Edition. Newdelhi: Churchill Livingstone, 2012, 1140-45. Adams R, Victor M, Ropper A. Cerebrovascular diseases. In: Wonsiezicz MJ and Narozov M, Editors. Principles of Neurology, 6th Edition, New York: McGraw-Hill, 1997, 834-40. King WA, Jacob L. Computerized Axial transverse tomography in C.V.A. Neurology. 1976; 26:924-30. Matsumoto Handa. CT guided sterotaxic evacuation of hypertensive ICH. Jr Neurosurgery 1984; 61:440-48. Jellinger K. Morphology and Aetiology. In Pia H.W, Langmaid C, Zierski Jan. Editors. Spontaneous Intracerebral Hematoma Advances in diagnosis and therapy, Springer-Verlag Berlin Heidelberg, 1980, 13-20. Piotrowski Prognosis, Discussion. In Pia HW, Langmaid C, Zierski Jan. Editors. Spontaneous Intracerebral Hematoma Advances in diagnosis and therapy, Springer-Verlag Berlin Heidelberg, 1980, 251-57. R Lorenz, Giessen: Epidemoiogy. In Pia HW, Langmaid C, Zierski Jan. Editors. Spontaneous Intracerebral Hematoma Advances in diagnosis and therapy, Springer-Verlag Berlin Heidelberg, 1980, 91-105. Anderson CS, Chakera TM, Stewart-Wynne EG, Jamrozik KD. Spectrum of primary intra cerebral haemorrhage in Perth, Western Australia, 1989-90: incidence and outcome. J Neurol Neurosurg Psychiatry. 1994; 57(8):936-40. doi: 10.1136/jnnp.57.8.936. PMID: 8057117; PMCID: PMC1073077. Gambhir Gupta Sing Shukla. Prognostic parameters of CT scan in Spontaneous Intra cerebral Hematoma. Neurol India. 1993; 41:151-55. RD Nagpal. ICH and their etiology in India. In Pia H.W, Langmaid C, Zierski Jan. Editors. Spontaneous Intracerebral Hematoma Advances in diagnosis and therapy, Springer-Verlag Berlin Heidelberg, 1980, 100-03. Seppo Juvela, Olli Heiskanen, Anti Poranen. The treatment of SICH. Jr Neurosurgery. 1989; 70:755-58. Imielinski BL, Kloc W. Spontaneous Intracerebral Hematomas: Clinical Appraisal of Surgical and Conservative Treatment. In: Lorenz R., Klinger M., Brock M. (eds) Intracerebr al Hemorrhage Hydrocephalus malresorptivus Peripheral Nerves. Advances in Neurosurgery, 1993, 21. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77997-8_2 Sanchetee PC, Dhamija RM, Roy AK, Venkataraman S. Peripartum cerebral venous thrombosis. J Assoc Physicians India. 1992; 40(10):664-6. PMID: 1344642. Kazui Seiji, Hiroaki Naritomi, Haruko Yamamoto: Enlargement of spontaneous intracerebral hemorrhage; incident and time course: Stroke. 1996; 27(10):1783- 87. F John Gillingham. Conservative and surgical management of Spontaneous Intracerebral Hematoma. In Pia H.W, Langmaid C, Zierski Jan. Editors. Spontaneous Intracerebral Hematoma Advances in diagnosis and therapy, Springer-Verlag Berlin Heidelberg, 1980, 391-92. Lewis B, Morgenstern J, Claude Hemphill III, Craig Anderson, Kyra Becker, Joseph P, et al. Guidelines for the management of spontaneous intra cerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2010; 41(9):2108-29. doi:10.1161/STR.0b013e3181ec611b Caplan LR. A History of Stroke: Its Recognition and Treatment. JAMA. 1990; 263(7):1017. doi:10.1001/jama.1990.03440070105046