Microscopical Surgical Treatment of Hypertensive Putaminal Hematomas through Transsylvian Transinsular Approach
XIONG Wen-hao, GE Jian-wei, ZHANG Xiao-hua, JIA Feng, QIU Yong-ming, LI Shan-quan, LUO Qi-zhong (Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China)
Objective To explore the effects of microscopical surgical treatment on patients with hypertensive putaminal hemorrhage through transsylvian transinsular approach. Methods From January 2002 to August 2005, thirty-seven patients with hypertensive putaminal hemorrhage received microscopical operation through transsylvian transinsular approach within 7 hours from the onset of the symptoms. According to the image of CT scan, hematoma within putamina area was removed with skull flap or skull window craniotomy, and intraventricular hematoma was also performed ventricular puncture and drainage. Results The postoperative CT scan showed that 32 patients was removed the hematoma for more than 90%, while 5 patients less than 70%.During the follow up of 6 to 12 months, 35 patients survived and 2 died.The therapeutic effects were evaluated by activities of daily living (ADL).There were good recovery or mild disablement (ADL scale 1~2) in 26 cases (70.3%), moderate disablement (ADL scale 3) in 4 cases (10.8%), severe disablement (ADL scale 4) in 4 cases (10.8%), and persistent vegetative state in 1 case (2.7%). Conclusion Microscopical operation through transsylvian transinsular approach is an effective method, which could protect cerebral vessels and brain tissues so as to decrease the deficit of nervous function.
【CateGory Index】： R651.1