Analysis of Early Outcome of Surgery in Spontaneous Primary Intracerebral Haemorrahage in Relation to Preoperative Glasgow Coma Scale

Abstract

Objectives : To correlate preoperative Glasgow coma scale with early outcome of surgery.

Methods: This prospective study was done at the department of neurosurgery of Dhaka Medical College (from January 2009 to June 2010) on consecutively selected patients with a suspicion of intracerebral haemorrhage and subsequently confirmed by CT scan of brain. A total of 30 hypertensive patients with their age ranged from 41 to 80 years with Glasgow coma scale 6 to 12 were included in this study. Co-morbid patients like cardiac, respiratory and renal failure requiring artificial maintenance of blood pressure and respiration were excluded in this study. All these patients were evaluated on the basis of detailed history from attendants (as patients were stuporous and semicomatose), clinical examination and subsequently CT scan of brain (at presentation and at 7th postoperative day). All these patients were operated and followed up during hospital stay and at 30-day after operation, by observing Glasgow coma scale and Glasgow outcome scale.

Results: 20 patients had Glasgow coma scale 6 to 8 on admission, among them Glasgow outcome scale was 5 in 4(20.0%) patients, was 3 in 4(20.0%) patients and was 1 in 12(60.0%) patients. 10 patients had Glasgow coma scale 9 to 12 on admission, among them Glasgow outcome scale was 5 in 6 (60.0%) patients, was 4 in 1(10.0%) patient and was 3 in 3(30.0%) patients.

Conclusion: Surgery in relation to preoperative Glasgow coma scale (Glasgow coma scale) had a significant correlation with early outcome of surgery. From the current study removal of haematoma when Glasgow coma scale >8 lower the morbidity and mortality, which was statistically significant

DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8633

BSMMU J 2011; 4(2):70-75