Surgery versus Conservative Treatment for Spontaneous Supratentorial Intracerebral Hemorrhage in Spot Sign Positive XXXX .

@entity1 @entity2653 @entity772 @entity1410 @entity1779
OBJECTIVE: An advantage of surgical treatment over conservative treatment of spontaneous @entity1779 ( @entity1779 ) is controversial. Recent reports suggest that contrast extravasations on CT angiography (CTA) might serve as a crucial predictor of @entity1410 expansion and mortality. The purpose of this study was aimed at investigating the efficacy of surgical treatment in @entity1 with spot sign positive @entity1779 . METHODS: We used our institutional medical data search system to identify all adult @entity1 who admitted for treatment of @entity1779 between January 1, 2007 and January 31, 2012. @entity1 were classified two groups into a surgical group (n=27) and a conservative treatment group (n=28). Admission criteria were the following: age 20-79 years, spontaneous supratentorial @entity1779 , Glasgow @entity772 Score Ranging from 9 to 14, @entity1779 volume >= 20 mL, and treatment within 24 hours. RESULTS: Fifty-five @entity1 were analyzed. There was no significant difference in the ICU stay between the conservative treatment group (7.36  3.66 days) and the surgical treatment group (6.93  2.20 days; p=0.950). There was a significant difference in the in-hospital stay between the conservative treatment group (13.93  8.87 days) and the surgical treatment group (20.33  6.37 days; p=0.001). Overall mortality at day 90 after @entity1779 was 36.4%; this included 16 of 28 @entity1 (57.1%) in the conservative group and 4 of 27 @entity1 (14.8%) in the surgical group. In univariate analysis, there was a positive effect of the surgical treatment in reducing mortality at 90 days (p=0.002), Glasgow Outcome Scale (GOS) at 90-day (p=0.006), and @entity2653 ( @entity2653 ) at 90-day (p=0.023). In multivariate logistic analysis, there was a significant difference in mortality (odds ratio, 0.211; 95% confidence interval, 0.049-0.906; p=0.036) between the groups at 90-day follow-up. However, there was no significant difference in GOS (odds ratio, 0.371; 95% confidence interval, 0.031-4.446; p=0.434) and @entity2653 (odds ratio, 1.041; 95% confidence interval, 0.086-12.637; p=0.975) between the groups at 90-day follow-up. CONCLUSION: In this study of surgical treatment of supratentorial @entity1779 in @entity1 with spot sign positive in CTA was associated with less mortality despite of long duration of in-hospital stay. We failed to show that clinical outcome benefit of surgical treatment compared with conservative treatment in @entity1 with spot sign positive @entity1779 .
