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Strategy of Drainage by Stereotactic Catheterization in Types of Hypertensive Hemorrhage in Deep Brain

XIE Cai-lan▲,PAN Jun,LU Jia-zhang,YANG Ling,LIN Kuan,JIN Dan,QI Song-tao.▲Department of Neurosurgery,Chen Xing-hai Hospital,Zhongshan 528415,China  
Objective: The strategy of drainage by stereotactic catheterization has been evaluated in treating patients with hypertensive hemorrhage in deep brain.Methods: According to hematoma features on CT,52 patients with the cerebral hemorrhage were fallen into 6 types.The criteria is following: type 1,uniform;type 2,asymmetry;type 3,obvious edematous cincture around the hematoma;type 4,large or irregular hematoma;type 5,hematoma ruptured into the ventricles;type 6,mixed type.The stereotactic draining was determined by the types.In type 1 patients,an enhanced CT was needed to guide the catheterization.The draining tube was posed to the middle point of the back border of the hematoma,avoiding the blood vessels.In type 2 cases,the catheterizing point was within the area with low CT value.In type 3 patients,catheterizing tube was placed on the region where the edema was obvious.In type 4 cases,two or more targets were selected.In type 5 cases,drainage of the hematoma and the ventricle at the same time were applied.In type 6 cases,the procedure was done according to the strategies above.Results: Of 52 patients,36 cases gained satisfactory recovery;11 cases moderately disabled;1 case severely disabled and 4 cases died.No rebleeding in the hemorrhagic region during the procedure was encountered,and 3 cases re-bled a little after the operation.Conclusion: The effect of drainage by stereotactic catheterization according to the types of the hypertensive bleeding in the deep brain is satisfactory,and the rate of re-bleeding is low.
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