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61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Prediction of clinical relevant haemorrhages after stereotactic operations

Meeting Abstract

Suche in Medline nach

  • Sebastian Eibach - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany
  • Lutz Weise - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany
  • Volker Seifert - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1673

DOI: 10.3205/10dgnc146, URN: urn:nbn:de:0183-10dgnc1463

Veröffentlicht: 16. September 2010

© 2010 Eibach et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Stereotactic biopsies have a high diagnostic value concerning brain lesions. Often postoperative CT scans are routinely performed in order to rule out intracerebral haemorrhages, even though the risk of a clinical apparent haemorrhage is very low with this procedure. The objective of this study is to find out the importance of these routine CT scans and the predictive value of any intra operative detected bleeding.

Methods: Prospectively 106 patients who underwent stereotactic biopsy were studied in the years 2009–2010. After frame based stereotactic biopsy a CT scan was performed in all patients to detect haemorrhages due to surgery. The incidence and the size of the haemorrhage was evaluated (more or less than 1 cm in diameter). Any intraoperative bleeding was documented and quantified prospectively by the surgeon (single drips, </=10 drips, > 10 drips). The correlation between intraoperative bleeding and postoperative haemorrhage was analysed.

Results: 32 patients (30.2%) had an intraoperative bleeding, 24 (75%) of them in terms of single drips, 6 (18.7.%) with less than 10 drips and 2 (6.3%) with more than 10 drips. In 14 (43.8%) of these patients haemorrhage was also detected in the postoperative CT scan.

All together 21 out of 106 patients (19.8%) showed haemorrhages in their postoperative CT scan. Of these, 18 (85.7%) showed haemorrhages with a diameter of less than 1 cm and 3 (14.3%) with a diameter of over 1 cm. In 15 out of these 21 patients (71.4%) bleeding already occurred intraoperatively. None of the hemorrhages were symptomatic. All of the larger haemorrhages detected on a postoperative CT scan (3 out of 3) showed intraoperative bleeding.

Conclusions: Stereotactic brain biopsies have a low risk for symptomatic haemorrhagic complications. Intraoperative bleedings are more frequent than haemorrhages detected on a postoperative CT scan. An intraoperative bleeding has a sensitivity of 71% and a predictive value of 44% for the detection of haemorrhages on a postoperative CT-scan. So far an intraoperative bleeding has preceded all larger haemorrhages. Therefore we conclude that postoperative CT scans could be restricted to patients who showed intraoperative bleeding.