Hematomas intracerebrais hipertensivos: a propósito de 50 casos

Lynch, José Carlos; Alves, Ricardo; Ribeiro, Ricardo; Lima, José Geraldo

doi:10.1590/S0004-282X1985000200007

Resumos

São analisados 50 pacientes com hematomas hipertensivos supratentoriais. A literatura pertinente é revista. As várias proposições de tratamento desta patologia são apresentadas e analisadas. Os autores também propõem uma rotina de tratamento para os hematomas hipertensivos supratentoriais.

Fifty cases of supratentorial intracerebral hematomas associated with hypertension are analyzed. The best treatment of the intracerebral hematomas is not settled. The authors reviewed and analyzed the literature and they suggest that the small hematomas should be managed conservatively as well as those patients in deep coma. The subcortical hematomas usually improve with surgical removal. In the deep ganglionic type the initial treatment is clinical. If no improvement occurs the hematoma should be removed with microsurgery tecnique.

Hematomas intracerebrais hipertensivos: a propósito de 50 casos

Intracerebral hematomas associated with hypertension: analysis of 50 cases

José Carlos Lynch^I; Ricardo Alves^II; Ricardo Ribeiro^II; José Geraldo Lima^II

^IChefe da Clínica. Clínica de Neurocirurgia do Hospital Cardoso Fontes, INAMPS, RJ

^IIMédico Assistente. Clínica de Neurocirurgia do Hospital Cardoso Fontes, INAMPS, RJ

RESUMO

São analisados 50 pacientes com hematomas hipertensivos supratentoriais. A literatura pertinente é revista. As várias proposições de tratamento desta patologia são apresentadas e analisadas. Os autores também propõem uma rotina de tratamento para os hematomas hipertensivos supratentoriais.

ABSTRACT

Fifty cases of supratentorial intracerebral hematomas associated with hypertension are analyzed. The best treatment of the intracerebral hematomas is not settled. The authors reviewed and analyzed the literature and they suggest that the small hematomas should be managed conservatively as well as those patients in deep coma. The subcortical hematomas usually improve with surgical removal. In the deep ganglionic type the initial treatment is clinical. If no improvement occurs the hematoma should be removed with microsurgery tecnique.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabalho da Clínica de Neurocirurgia do Hospital Cardoso Fontes, INAMPS, RJ.

Agradecimentos: Os autores agradecem aos Drs. Amauri de Carvalho e Nelson Moraes pela ajuda e apoio prestados à Clínica de Neurocirurgia.

Centro Profissional Jardim Botânico - Rua Jardim Botânico, 100, s/318 - 22461, Rio de Janeiro. RJ - Brasil.

1. AKERMAN, A. & NIEMEYER, P. - Hematoma cerebral espontâneo. Med. Cir. Farm. 202:53, 1953.
2. AOKI, N. & MIZTJTANI, H. - Does Moyamoya disease cause subarachnoid hemorrhage? Review of 54 cases with intracranial hemorrhage confirmed by computerized tomography. J. Neurosurg. 60:348, 1984.
3. BASSET, R.C.; ROGER, J.S.; CHERRY, G.R. & GRUZHIT, C. - The effects of contrast media on the blood-brain-barrier. J. Neurosurg. 10:38, 1983.
4. BENES, V.; KOUKOLIK, K. & OBROVSKA, D. - Two types of spontaneous intracerebral hemorrhage due to hypertension. J. Neurosurg. 37:509, 1972.
5. BUTZER, J.F.; CANCILLA, P.A. & CONELL, S.H. - Computarized axial tomography of intracerebral hematoma. A clinical and neuropathological study. Arch. Neurol. 33:206, 1976.
6. CAHILL, D.W. & DUCKER, T.B. - Spontaneous intracerebral hemorrhage. Clin. Neurol. 29:722, 1982.
7. COHEN, H.C.M.; TUCKER, W.S.; HUMPHREYS, R.P. & PERRIN, R.J. - Angiographically cryptic histologically verified cerebrovascular malformations. Neurosurg. 10:704, 1982.
8. COOK, A.W.; PLAUT, M. & BRAUDER, J. - Spontaneous intracerebral hemorrhage. Factors related to surgical results. Arch. Neurol. 13:25, 1966.
9. CUATICO, W.; ADIB, S. & GASTON, P. - Spontaneous intracerebral hematomas. A surgical appraisal. J. Neurosurg. 22:569, 1965.
10. DAVIDOFF, L.M. - Intracerebral hemorrhage associated with hypertension and arteriosclerosis. J. Neurosurg. 15:322, 1958.
11. DUFF, T.A.; AYENI, S.; LEVIN, A.B. & JAVID, M. - Nonsurgical management of spontaneous intracerebral hematoma. Neurosurg. 9:387, 1981.
12. FEIN, J. - Hypertension and central nervous system. Clin. Neurosurg. 29:666, 1982.
13. FERREIRA, N.P.; CHAVES, D.L. & KRAEMER, J.D. - Hematomas intraparenquimatosos espontâneos supratentoriais. Arq. Neuro-Psiquiat. (São Paulo) 38:367, 1980.
14. FRENCH, B.N.; NIELSON, S.; REWCOSTLE, N.B. & St. JOHN, J. - Spontaneous intracerebral hemorrhage in association with cerebral amyloid congophilic angiopathy. In H. Dietz, F. Metzel & C. Langmaid (eds.) - Neurological Surgery Abstracts of the 7th International Congress of Neurological Surgery. Geog Thieme Verlag, Stuttgart, 1981, pg. 351.
15. GOMENSORO, J.B. & IÑIGUEZ, R.A. - Surgical treatment of spontaneous cerebral hemorrhage. Survey of 50 cases. Acta neurol. latinoamer. 3:236, 1957.
16. GUIDETTI, B. & GAGLIARDI, F. - Experiences with operations in 149 cases of spontaneous ICH. In P.W. Pia., C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 247.
17. HANEY, W.P. & PRESTON, R.E. - Ocular complications of carotid arteriography in carotid oclusive disease. Arch. Ophthal. 67:33, 1962.
18. HOROWITZ, N.H. & WENER, L. - Temporary cortical blindness following angiography. J. Neurosurg. 40:583, 1974.
19. HOWIESON, J. - Complications of cerebral angiography. In T.H. Newton, & D.G. Potts (eds.) - Radiology of the Skull and Brain. Vol. 2, Book 2. C.V. Mosby, St. Louis, 1974, pg. 1034.
20. HOWLAND, W.J. & CURRY, J.L. - Transient cerebral blindness. A hazard of vertebral artery catheterization. Radiology 83:428, 1964.
21. JELLINGER, K. - Pathology and etiology of ICH. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 13.
22. JENSEN, H.D. - Micro angiomas and ICH. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 41.
23. KANAYA, H.; YUKAWA, H.; ITOH, Z.; KUTSUZAWA, H.; KAGAWA, M.; KANNO, T.; KUWABARA, T.; MIZUKAMI, M.; ARAKI, G. & IRINO, T. - Grading and the indications for treatment in ICH of the basal ganglia (cooperative study in Japan). In P.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 268.
24. KANEKO, M.; KOBA, T. & YOKOYAMA, T. - Early surgical treatment tor hypertensive intracerebral hemorrhage. J. Neurosurg. 46:579, 1977.
25. KANEKO, M.; TANAKA, K.; SHIMADA, T.; SATO, K. & UEMURA, K. - Longterm evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J. Neurosurg. 58:838, 1983.
26. KITAMURA, K. & KAGAWA, M. - Indications for operative treatment of hypertensive ICH in the basal ganglia and thalamus. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 334.
27. LORENZ, R. - Epidemiology of ICH in Europe. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 91.
28. LAZORTHES, G. - Surgery of cerebral hemorrhage: report of the results 52 surgically treated cases. J. Neurosurg. 16:335, 1959.
29. LUESSENHOP, A..J.; SHEVLIN, W.A.; FERRERO, A.A., McCULLOUGH, D.C. & BARONE, B.M. - Surgical management of primary intracerebral hemorrhage. J. Neurosurg. 27:419, 1967.
30. McCORMICK, W.F. & NOFZINGER, J.D. - «Criptic» vascular malformations of the central nervous system. J. Neurosurg. 24:865, 1966.
31. McKISSOCK, W.; RICHARDSON, A. & TAYLOR, J. - Primary intracerebral hemorrhage. A controlled trial of surgical and conservative treatment in ISO unselect cases. Lancet 2:221, 1961.
32. McKISSOCK, W.; RICHARDSON, A. & WALSH, L. - Primary intracerebral hemorrhage. Results of surgical treatment in 244 consecutive cases. Lancet 2:683, 1959.
33. MITSUNO, T.; KANAYA, H.; SHIRAKATA, S.; OHSAWA, K. & ISHIKAWA, Y. - Surgical treatment of hypertensive intracerebral hemorrhage. J. Neurosurg. 24:70, 1966.
34. MUTLU, N.; BERRY, R.G. & ALPERS, B. - Massive cerebral hemorrhage. Clinical and pathological correlations. Arch. Neurol. 8:74, 1963.
35. OJEMANN, R.G. & MOHR, J.P. - Hypertensive brain hemorrhage. Clin. Neurosurg. 23:220, 1976.
36. PAILLAS, J.E. & ALLIEZ, B. - Surgical treatment of spontaneous intracerebral hemorrhage. Immediate and long-term results in 250 cases. J. Neurosurg. 39:145, 1973
37. PAPO, I.; JANNY, P.; CARUSELLI, G.; GOLNET, G. & LUONGO, A. - Intracranial pressure time course in primary intracerebral hemorrhage. Neurosurgery 4:504, 1979.
38. PASZTOR, E.; AFRA, P. & OROSZ, E. - Experiences with the surgical treatment of 156 ICH. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 251.
39. PICARD, L.; ROLAND, J.; LE POIRE, J. & MONTAUT, J. - The role of angiography in the neuroradiological diagnosis of intracerebral hematomas. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 171.
40. PRIBRAM, H.F.W. - Complications of angiography in cerebrovascular disease. Radiology 85:33, 1965.
41. RANSOHOFF, J.; DERBY, B. & KRICHEFF, I. - Spontaneous intracerebral hemorrhage. Clin. Neurosurg. 28:247, 1970.
42. RAPOPORT, S.I. & LEVITAN, H. - Neurotoxicity of X-Ray contrast media. Amer. J. Roentgenol. 122:186, 1974.
43. SCOTT, M. - Neurosurgical treatment of spontaneous intracranial hemorrhage. J. amer. med. Assoc. 172:889, 1950.
44. SILVERMAN, S.M.; BERGMAN, P.S. & BENDER, M.B. - The dynamics of transient cortical blindness. Report of nine episodies following vertebral angiography. Arch. Neurol. 4:333, 1961.
45. SUZUKI, J. & SATO, T. - Grading and timing of operation in putaminal ICH. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 274.
46. SUZUKI, J. & SATO, T. - Trans-Sylvian approach in putaminal ICH with mild symptoms. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 345.
47. TEDESCHI, G.; BERNINI, F.P. & CERILLO, A. - Indications for surgical treatment of intracerebral hemorrhage. J. Neurosurg. 43:590, 1975.
48. TYLER, K.L., POLETTI, C.E. & HEROS, R.C. - Cerebral amyloid angiopathy with multiple intracerebral hemorrhage. Case report. J. Neurosurg. 57:286, 1982.
49. VANDERARK, G.D. & KAHN, A.E. - Spontaneous intracerebral hematoma. J. Neurosurg. 28:252, 1968.
50. WISHART, D.L. - Complications in vertebral angiography as compared with non-vertebral angiography in 471 studies. Amer. J. Roentgenol. 113:537, 1971.
51. ZHONG-XIU, C. - Treatment of intracranial hematoma with traditional Chinese herbs. In H. Dietz, E. Metzel & C. Langmaid - Neurological Surgery Abstracts of the 7th International Congress of Neurological Surgery. Georg Thieme Verlag, Stuttgart, 1981, pg. 93.
52. ZÜLCH, K.J. - Stroke. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 1.

Datas de Publicação

Publicação nesta coleção
13 Ago 2012
Data do Fascículo
Jun 1985

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AKERMAN, A. & NIEMEYER, P. - Hematoma cerebral espontâneo. Med. Cir. Farm. 202:53, 1953.

[2] 2. AOKI, N. & MIZTJTANI, H. - Does Moyamoya disease cause subarachnoid hemorrhage? Review of 54 cases with intracranial hemorrhage confirmed by computerized tomography. J. Neurosurg. 60:348, 1984.

[3] 3. BASSET, R.C.; ROGER, J.S.; CHERRY, G.R. & GRUZHIT, C. - The effects of contrast media on the blood-brain-barrier. J. Neurosurg. 10:38, 1983.

[4] 4. BENES, V.; KOUKOLIK, K. & OBROVSKA, D. - Two types of spontaneous intracerebral hemorrhage due to hypertension. J. Neurosurg. 37:509, 1972.

[5] 5. BUTZER, J.F.; CANCILLA, P.A. & CONELL, S.H. - Computarized axial tomography of intracerebral hematoma. A clinical and neuropathological study. Arch. Neurol. 33:206, 1976.

[6] 6. CAHILL, D.W. & DUCKER, T.B. - Spontaneous intracerebral hemorrhage. Clin. Neurol. 29:722, 1982.

[7] 7. COHEN, H.C.M.; TUCKER, W.S.; HUMPHREYS, R.P. & PERRIN, R.J. - Angiographically cryptic histologically verified cerebrovascular malformations. Neurosurg. 10:704, 1982.

[8] 8. COOK, A.W.; PLAUT, M. & BRAUDER, J. - Spontaneous intracerebral hemorrhage. Factors related to surgical results. Arch. Neurol. 13:25, 1966.

[9] 9. CUATICO, W.; ADIB, S. & GASTON, P. - Spontaneous intracerebral hematomas. A surgical appraisal. J. Neurosurg. 22:569, 1965.

[10] 10. DAVIDOFF, L.M. - Intracerebral hemorrhage associated with hypertension and arteriosclerosis. J. Neurosurg. 15:322, 1958.

[11] 11. DUFF, T.A.; AYENI, S.; LEVIN, A.B. & JAVID, M. - Nonsurgical management of spontaneous intracerebral hematoma. Neurosurg. 9:387, 1981.

[12] 12. FEIN, J. - Hypertension and central nervous system. Clin. Neurosurg. 29:666, 1982.

[13] 13. FERREIRA, N.P.; CHAVES, D.L. & KRAEMER, J.D. - Hematomas intraparenquimatosos espontâneos supratentoriais. Arq. Neuro-Psiquiat. (São Paulo) 38:367, 1980.

[14] 14. FRENCH, B.N.; NIELSON, S.; REWCOSTLE, N.B. & St. JOHN, J. - Spontaneous intracerebral hemorrhage in association with cerebral amyloid congophilic angiopathy. In H. Dietz, F. Metzel & C. Langmaid (eds.) - Neurological Surgery Abstracts of the 7th International Congress of Neurological Surgery. Geog Thieme Verlag, Stuttgart, 1981, pg. 351.

[15] 15. GOMENSORO, J.B. & IÑIGUEZ, R.A. - Surgical treatment of spontaneous cerebral hemorrhage. Survey of 50 cases. Acta neurol. latinoamer. 3:236, 1957.

[16] 16. GUIDETTI, B. & GAGLIARDI, F. - Experiences with operations in 149 cases of spontaneous ICH. In P.W. Pia., C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 247.

[17] 17. HANEY, W.P. & PRESTON, R.E. - Ocular complications of carotid arteriography in carotid oclusive disease. Arch. Ophthal. 67:33, 1962.

[18] 18. HOROWITZ, N.H. & WENER, L. - Temporary cortical blindness following angiography. J. Neurosurg. 40:583, 1974.

[19] 19. HOWIESON, J. - Complications of cerebral angiography. In T.H. Newton, & D.G. Potts (eds.) - Radiology of the Skull and Brain. Vol. 2, Book 2. C.V. Mosby, St. Louis, 1974, pg. 1034.

[20] 20. HOWLAND, W.J. & CURRY, J.L. - Transient cerebral blindness. A hazard of vertebral artery catheterization. Radiology 83:428, 1964.

[21] 21. JELLINGER, K. - Pathology and etiology of ICH. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 13.

[22] 22. JENSEN, H.D. - Micro angiomas and ICH. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 41.

[23] 23. KANAYA, H.; YUKAWA, H.; ITOH, Z.; KUTSUZAWA, H.; KAGAWA, M.; KANNO, T.; KUWABARA, T.; MIZUKAMI, M.; ARAKI, G. & IRINO, T. - Grading and the indications for treatment in ICH of the basal ganglia (cooperative study in Japan). In P.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 268.

[24] 24. KANEKO, M.; KOBA, T. & YOKOYAMA, T. - Early surgical treatment tor hypertensive intracerebral hemorrhage. J. Neurosurg. 46:579, 1977.

[25] 25. KANEKO, M.; TANAKA, K.; SHIMADA, T.; SATO, K. & UEMURA, K. - Longterm evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J. Neurosurg. 58:838, 1983.

[26] 26. KITAMURA, K. & KAGAWA, M. - Indications for operative treatment of hypertensive ICH in the basal ganglia and thalamus. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 334.

[27] 27. LORENZ, R. - Epidemiology of ICH in Europe. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 91.

[28] 28. LAZORTHES, G. - Surgery of cerebral hemorrhage: report of the results 52 surgically treated cases. J. Neurosurg. 16:335, 1959.

[29] 29. LUESSENHOP, A..J.; SHEVLIN, W.A.; FERRERO, A.A., McCULLOUGH, D.C. & BARONE, B.M. - Surgical management of primary intracerebral hemorrhage. J. Neurosurg. 27:419, 1967.

[30] 30. McCORMICK, W.F. & NOFZINGER, J.D. - «Criptic» vascular malformations of the central nervous system. J. Neurosurg. 24:865, 1966.

[31] 31. McKISSOCK, W.; RICHARDSON, A. & TAYLOR, J. - Primary intracerebral hemorrhage. A controlled trial of surgical and conservative treatment in ISO unselect cases. Lancet 2:221, 1961.

[32] 32. McKISSOCK, W.; RICHARDSON, A. & WALSH, L. - Primary intracerebral hemorrhage. Results of surgical treatment in 244 consecutive cases. Lancet 2:683, 1959.

[33] 33. MITSUNO, T.; KANAYA, H.; SHIRAKATA, S.; OHSAWA, K. & ISHIKAWA, Y. - Surgical treatment of hypertensive intracerebral hemorrhage. J. Neurosurg. 24:70, 1966.

[34] 34. MUTLU, N.; BERRY, R.G. & ALPERS, B. - Massive cerebral hemorrhage. Clinical and pathological correlations. Arch. Neurol. 8:74, 1963.

[35] 35. OJEMANN, R.G. & MOHR, J.P. - Hypertensive brain hemorrhage. Clin. Neurosurg. 23:220, 1976.

[36] 36. PAILLAS, J.E. & ALLIEZ, B. - Surgical treatment of spontaneous intracerebral hemorrhage. Immediate and long-term results in 250 cases. J. Neurosurg. 39:145, 1973

[37] 37. PAPO, I.; JANNY, P.; CARUSELLI, G.; GOLNET, G. & LUONGO, A. - Intracranial pressure time course in primary intracerebral hemorrhage. Neurosurgery 4:504, 1979.

[38] 38. PASZTOR, E.; AFRA, P. & OROSZ, E. - Experiences with the surgical treatment of 156 ICH. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 251.

[39] 39. PICARD, L.; ROLAND, J.; LE POIRE, J. & MONTAUT, J. - The role of angiography in the neuroradiological diagnosis of intracerebral hematomas. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 171.

[40] 40. PRIBRAM, H.F.W. - Complications of angiography in cerebrovascular disease. Radiology 85:33, 1965.

[41] 41. RANSOHOFF, J.; DERBY, B. & KRICHEFF, I. - Spontaneous intracerebral hemorrhage. Clin. Neurosurg. 28:247, 1970.

[42] 42. RAPOPORT, S.I. & LEVITAN, H. - Neurotoxicity of X-Ray contrast media. Amer. J. Roentgenol. 122:186, 1974.

[43] 43. SCOTT, M. - Neurosurgical treatment of spontaneous intracranial hemorrhage. J. amer. med. Assoc. 172:889, 1950.

[44] 44. SILVERMAN, S.M.; BERGMAN, P.S. & BENDER, M.B. - The dynamics of transient cortical blindness. Report of nine episodies following vertebral angiography. Arch. Neurol. 4:333, 1961.

[45] 45. SUZUKI, J. & SATO, T. - Grading and timing of operation in putaminal ICH. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 274.

[46] 46. SUZUKI, J. & SATO, T. - Trans-Sylvian approach in putaminal ICH with mild symptoms. In H.W. Pia, C. Langmaid & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 345.

[47] 47. TEDESCHI, G.; BERNINI, F.P. & CERILLO, A. - Indications for surgical treatment of intracerebral hemorrhage. J. Neurosurg. 43:590, 1975.

[48] 48. TYLER, K.L., POLETTI, C.E. & HEROS, R.C. - Cerebral amyloid angiopathy with multiple intracerebral hemorrhage. Case report. J. Neurosurg. 57:286, 1982.

[49] 49. VANDERARK, G.D. & KAHN, A.E. - Spontaneous intracerebral hematoma. J. Neurosurg. 28:252, 1968.

[50] 50. WISHART, D.L. - Complications in vertebral angiography as compared with non-vertebral angiography in 471 studies. Amer. J. Roentgenol. 113:537, 1971.

[51] 51. ZHONG-XIU, C. - Treatment of intracranial hematoma with traditional Chinese herbs. In H. Dietz, E. Metzel & C. Langmaid - Neurological Surgery Abstracts of the 7th International Congress of Neurological Surgery. Georg Thieme Verlag, Stuttgart, 1981, pg. 93.

[52] 52. ZÜLCH, K.J. - Stroke. In H.W. Pia, C. Langmaid, & J. Zierski (eds.) - Spontaneous Intracerebral Hematomas. Advances in Diagnosis and Therapy. Springer-Verlag, Berlin, 1980, pg. 1.