Clinical study of microsurgical treatment of pontine hemorrhage with retrosigmoid approach from the cer-ebellopontine angle
10.3969/j.issn.1002-0152.2023.11.004
- VernacularTitle:桥小脑角乙状窦后入路显微手术治疗脑桥出血临床研究
- Author:
Henghao WU
1
;
Juanru SHEN
;
Jingbo WANG
;
Shengxu ZHANG
;
Zheng SONG
;
Wentao YANG
;
Wanhong ZHANG
Author Information
1. 开封市中心医院神经外科(开封 475000)
- Keywords:
Brainstem;
Pontine hemorrhage;
Retrosigmoid approach;
Microsurgery;
Modified Rankin score;
Fatality rate;
Complication
- From:
Chinese Journal of Nervous and Mental Diseases
2023;49(11):659-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of the retrosigmoid sinus approach through the cerebellopontine angle in the treatment of pontine hemorrhage.Methods A retrospective analysis was performed on 108 patients with pontine hemorrhage in Kaifeng Central Hospital from January 2016 to June 2022.They were divided into two groups according to the treatment methods,the conservative treatment group and the craniotomy treatment group(transcerebellopontine angle sigmoid sinus posterior approach).There were 94 cases in the conservative treatment group and 14 cases in the surgical treatment group.First analysis was conducted to examined whether there are differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.Additional analysis was performed to analyze modified Rankin(modified Rankin scale,mRS)score and mortality rate after three month follow-up in case there was no significant difference at first analysis.Results There were no statistical differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.After 3 months of follow-up,49 patients died in the conservative treatment group and 3 patients in the craniotomy treatment group.The mortality rates of the two groups were 52.1％and 21.4％respectively(χ2=4.600,P<0.05)).There was a statistical difference in the mortality rate between the two groups,and the mortality rate of the craniotomy treatment group was significantly lower than that of the conservative group.The modified Rankin score was 4(3,5)in the conservative treatment group and 3(2,3)in the craniotomy group(Z=-2.994,P<0.01).The modified Rankin score in the craniotomy group was lower than that in conservative treatment group after 3 months.Conclusion Microsurgery through the cerebellopontine angle retrosigmoid sinus approach to treat pontine hemorrhage can significantly reduce patient mortality and improve prognosis and is an effective surgical treatment method.
