Changes in cerebral hemodynamics and cerebral oxygenation during surgical evacuation for hypertensive intracerebral putaminal hemorrhage.

OBJECTIVES The aim of this study was to evaluate the changes in cerebral hemodynamics, tissue oxygenation and blood flow before and after surgery for spontaneous intracerebral hematomas. METHODS Eleven patients who underwent surgical decompression of spontaneous putaminal hematoma were studied. Intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain tissue oxygen (PtiO2), and carbon dioxide tensions (PtiCO2), brain pH and regional cerebral blood flow (rCBF) were recorded prior to removing the bone flap and then on skin closure on completion of the operation. RESULTS Following surgical decompression, mean ICP decreased significantly (P < 0.05); mean CPP, PtiO2, brain pH and rCBF improved although the changes were not significant. CONCLUSION Surgical decompression for spontaneous intracerebral hematomas leads to significant reductions in ICP. This is accompanied by improvements in CPP, PtiO2 and rCBF in the penumbra.