SURGERY FOR HYPERTENSIVE BLEEDS

What is hypertensive bleeding?
Hypertensive bleeding occurs when there is bleeding in the brain as a result of high blood pressure. This can cause haemorrhaging on the brain and stroke. Intracerebral haemorrhages caused by hypertension are prevalent. They can be easily split into categories based on their common locations, which include, in order of frequency:

  • Basal ganglia haemorrhage - The most prevalent type of intracerebral haemorrhage is basal ganglia haemorrhage, which occurs due to poorly controlled long-term hypertension.
  • Thalamic haemorrhage - Thalamic haemorrhagic strokes are haemorrhagic strokes that originate in the thalamus and are frequently caused by persistent hypertension.
  • Pontine haemorrhage - Pontine haemorrhage, a type of cerebral bleeding, is usually caused by chronic hypertension that has been poorly controlled for a long time.
  • Cerebellar haemorrhage - Cerebellar haemorrhage is a type of cerebral bleeding that most commonly occurs due to poorly controlled hypertension. At the same time, it can also occur due to an underlying lesion (such as a tumour or vascular malformation) or as a result of supratentorial surgery.

What is an external ventricular drain?
An external ventricular drain is a tube that is inserted into the brain in order to relieve intracranial pressure and to treat hydrocephalus. It is inserted under general anaesthesia, and the procedure typically takes around ninety minutes. Your surgeon will make an incision behind the ear and drill a small hole into the skull through which a tube is inserted. This allows excess fluid to drain from the brain into other parts of the body, where it can be reabsorbed. The procedure is very safe and effective, but it is necessary to stay in the hospital for a few days after surgery so that the medical team can monitor your recovery.

What is a decompressive craniotomy for stroke?
A decompressive craniotomy is conducted when there is severe brain swelling caused by stroke. The procedure helps to prevent pressure from building up inside the skull and is performed by opening up a part of the bone in the skull.

FAQ:

The drain will be implanted during a one- to two-hour surgery under general anaesthesia.

  • If the intracranial pressure has been typical (15 mm Hg) over the previous 24 hours and there are no clinical indications or symptoms of hydrocephalus.
  • If the device's results are no longer accurate
  • If the ventricular drainage system is no longer working or is no longer necessary.
  • If the danger of infection outweighs the advantages of keeping the ICP device in place

The drain is tunnelled subcutaneously after EVD insertion and fastened with surgical sutures and/or surgical staples. The EVD, on the other hand, has the potential to detach or migrate.

DR SACHIN R. NAIDOO

I am a qualified neurosurgeon following my pre- and postgraduate studies at the University of Stellenbosch and currently have private practices at Netcare N1 City, which caters for the northern suburbs of Cape Town and Netcare Blaauwberg Hospital, which caters for the west coast of Cape Town and Western Cape.

CONTACT

Netcare Blaauwberg Hospital
Tel: +27 (0)21 554 0779 / Fax: +27 (0)21 554 2144

Email: bbhinfo@capeneurospine.co.za


Netcare N1 City Hospital
Tel: 021 595 4633 / Fax: 021-595 3446

Email: info@capeneurospine.co.za