Postoperative Outcome Of The Patient With CAAH And Curative Effect Of Xnj

Background and purpose: The cerebral amyloid angiopathy (CAA) is put forward in the beginning of this century, but the relations with intracerebral hemorrhage (ICH) are only taken until the 70's. In the domestic senior citizen the CAA formation rate and the overseas report are similar. Incidence of the CAA in the senior citizen's brain increases with the age. The research indicated CAA has become the important pathological foundation of ICH. The CAA-related ICH (CAAH) approximately composes 10% of the primary ICH. It is one of the main pathogenicities of the primary ICH, especially one of recurrent primary ICH, in the advanced age old crowd. After removes other reason that cause ICH, on clinical, the multiple, recurrent intracerebral lobar hemorrhage (RLH) should consider CAAH in the elderly.The therapeutic standard of CAAH is the same as one of other ICH. Studies have suggested that neurosurgical procedures in patients with CAA don't precipitate clinically significant postoperative hemorrhage (POH) and that intracerebral hematoma evacuation improves their neurological condition.There isn't still report of the outcome of patients with CAAH who were taken by "Xingnaojin injection"(Xnj).The purpose of this study was to elucidate the clinical factors influencing the outcome of patients with CAAH treated surgically and taken by Xnj. Then to appraise the effect of Xnj that relieve the consciousness obstacles of the patient with CAAH and and the long-dated curative effect.Method: This study reviewed their clinical and follow-up data of 31 patients with CAAH, that divided into two groups: Surgical treatment +Xnj treatment group (Xnj group) are 19 cases, the surgical treatment group (NeuS group), their clinical data were examined retrospectively and subjected to logistic regression analysis. The use of the Glasgows outcome score (GOS) and the Activity of daily life (ADL) for the appraisal to patient's prognosis.Results: A total of 39 neurosurgical procedures (31 intracerebral heamatoma evacuations, 2 ventriculoperitoneal shunts, 6 ventricular drainages) were performed in 31 patients with CAAH. We performed 14, 17 intracerebral hematoma evacuations by means of craniotomy, small craniotomy, respectively. 10(32.2%)intracerebral hematomas were evacuated on the day of the hemorrhage (day 0), 15 (48.4%)on days 1 to 3, and 6(19.4%)on day 4. Sixteen patients (51.6%) had a good outcome, and only 4 (12.9%) died. 3 have POH, but did not need the surgical treatment.Conclusion: Advanced age (≥75 years), the size of heamatoma (large,≥60 ml) and SAH had significant adverse influence on the postoperative outcome. Neurosurgery can be performed relatively safely in patients with CAAH, and Xnj too. Use of Xnj can relieve consciousness obstacles. Meanwhile should emphasize the individual treatment (include the surgery way).