On different operative methods for hypertensive intracerebral hemorrhage at different locations
- VernacularTitle:不同部位高血压性脑出血不同术式的探讨
- Author:
Peng XU
;
Yanju WANG
- Publication Type:Journal Article
- Keywords:
Hypertension;
Brain hemorrhage
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss effective methods for treating hypertensive intracerebral hemorrhage at the different sites. Methods Different operative methods were adopted in 85 cases of hypertensive intracerebral hemorrhage at the different sites from January 2001 to August 2003 in this hospital. Small fenestration and hematoma clearance under local intensify anesthesia was conducted in 40 cases of hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia; small incision trepanation with suction and drainage of hemorrhage under local intensify anesthesia was used in 26 cases of hemorrhage in the medial area of the basal ganglia without brain hernia; craniotomy and hematoma clearance under general anesthesia was adopted in 11 cases of preoperative brain hernia and 6 cases of cerebellar hemispheric hemorrhage; lateral ventricle external drainage was adopted in 2 cases of brain stem hemorrhage involving into the fourth ventricle and also in these cases with ventricle involved. Results The overall mortality rate was 12 9% (11/85). There were no deaths in cases of hemorrhage without brain hernia,under the cortex, in the cerebellum, in the brain stem or in the lateral area of the basal ganglia.The mortality was 29 0% (9/31) in cases of hemorrhage in the medial area of the basal ganglia and 45 5% (5/11) in cases of preoperative brain hernia, respectively. Conclusions Small fenestration and hematoma clearance under local anesthesia is effective for hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia. Provided surgical treatment is early and adequate, the prognosis of cerebellar hemorrhage is excellent. Small incision trepanation with suction and drainage under local anesthesia exerts no appreciable effect on hemorrhage in the medial area of the basal ganglia.
