"Functional outcome in surgical treatment of spontaneous intracranial hemorrhage"

Syed Sayed Ahmed, Md. Nurul Akhter, Sourav Chowdhury, Asfaquzzaman and Saif Ul Hoque

United Hospital Limited Dhaka, Bangladesh

DOI: 10.29011/2577-1442-C1-002

Objective: Incidence of intracranial hemorrhage has been increasing worldwide but mortality and morbidity has not fallen. Early diagnosis, hemostasis, management of Blood Pressure and coordinated primary and specialty care including specifically targeted critical care, open and/or minimally invasive surgical technique to remove hematoma and management of Intracranial pressure definitely reduce mortality and improve functional outcome significantly. The aim of this study is to show how we achieved it.

Materials and method:This is a retrospective study based on the records of 200 patients admitted in United Hospital Limited Dhaka, Bangladesh with spontaneous intracerebral hematoma, from January 2015 to December 2018. All these patients underwent surgical treatment.

Results: Among these 200 patients 97 (48.5%) underwent craniotomy and removal of hematoma; 28 (14%) had craniectomy and removal of hematoma, insertion of external ventricular drain 31 (15.5%); clipping or coiling required for 19 (9.5%) and craniotomy and insertion of external ventricular drain was done for 25 (12.5%) patients.

Conclusion: We provide open door policy and treat patients with severely compromised cardiac and renal functions and a good number of cases as a complication of cardiac intervention or investigation like use of multidrug antiplatelet therapy and/or thrombolytic agents. Even with all these co-morbidities dedicated neurosurgical team, effective surgical method and focused ICU care can make a great deal of difference regarding mortality and morbidity of this group of patients.

Keywords: Spontaneous Intracranial Hemorrhage (SICH), hypertensive stroke, craniotomy and external ventricular drain.


Syed Sayed Ahmed has passed the FRCS Examination in June 1996. Since then he worked in neurosurgery for National Health services of UK at Western General Hospital, Edinburgh; Radcliff infirmary: University of oxford and Walsgrave Hospital, University of Warwick, UK. In 2003 he returned to Bangladesh to join Apollo Hospital Dhaka as Consultant Neurosurgeon . In 2007 he Joined United Hospital Dhaka as Consultant Neurosurgery and Director, Neuro Centre. During his service in UK (Approx. 12 years) he successfully completed different training course in Edinburgh and Oxford. Among these GDC Training course for coiling of cerebral aneurysm organized by University of Oxford in remarkable. His special interest is in Treatment of subarachnoid haemorrhage.