Ultra-early Small Bone Window Craniotomy Operation for Hypertensive Cerebral Hemorrhage in Basal Ganglia Regions_West China Medical Journal

Authors：

 TANGBing-hong , QINZong-ming , CHENJian-gang , YANGMing-bin

Department of Neurosurgery, the Second People's Hospital of Shuangliu, Shuangliu, Sichuan 610213, P. R. China;

Corresponding author：

Keywords：

Basal ganglia regions; Hypertensive cerebral hemorrhage; Small bone window; Ultra-early

DOI：

10.7507/1002-0179.20150408

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Objective To explore the advantages and operation skills of ultra-early small bone window craniotomy surgery on cerebral hemorrhage in basal ganglia regions. Methods We retrospectively analyzed the clinical data of 58 patients with cerebral hemorrhage in basal ganglia regions who underwent ultra-early small bone window craniotomy between January 2009 and December 2012. Results Patients within 24 hours after surgery were re-checked by CT scan, which showed that hematoma was cleared in 53 cases, most removed in 2 cases, re-hemorrhage occurred in 2 patients whose hematoma was immediately removed by the original incision, 1 patient had large area infarction and underwent bone flap decompression. According to Glasgow outcome scale score at discharge, the outcome was good in 23, moderate disability in 18, severe disability in 12, persistent vegetative state in 2 and 3 were dead. Conclusion Ultra-early skull-window craniotomy can timely and completely remove the hematoma, provide reliable coagulation, protect important arteries with less re-hemorrhage and excellent outcome, which is one of the most effective methods for treating cerebral hemorrhage in basal ganglia regions.

Citation： TANGBing-hong, QINZong-ming, CHENJian-gang, YANGMing-bin. Ultra-early Small Bone Window Craniotomy Operation for Hypertensive Cerebral Hemorrhage in Basal Ganglia Regions. West China Medical Journal, 2015, 30(8): 1415-1418. doi: 10.7507/1002-0179.20150408 Copy

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1. 邬东晓, 张俊义, 王建军, 等. 高血压脑出血的外科治疗体会[J]. 内蒙古民族大学学报, 2009, 7(5):90-91.
2. 王忠诚. 神经外科学[M]. 武汉:湖北科学技术出版社, 1998:687.
3. 附鹏程, 陈继华, 夏明万, 等. ImagJ测量颅内血肿体积与多田公式的比较评价[J]. 海南医学, 2011, 22(5):75-77.
4. 董伟, 蔡可胜, 朱守明. 经外侧裂入路显微手术治疗高血压性基底节区脑出血32例[J]. 中国临床神经外科杂志, 2012, 17(7):428-430.
5. 陈卉. 小骨窗开颅术治疗中等量基底节区高血压脑出血的临床疗效[J]. 四川医学, 2012, 33(11):1950-1952.
6. 游潮. 李浩.进一步重视和规范高血压脑出血的外科治疗[J]. 中华神经外科杂志, 2011, 27(8):757-758.
7. Xu Y, Wanga Y, Feng L, et al. Treatment and outcome of intracranial hemorrhage after carotid artery stenting. A ten year single center experience[J]. Interv Neuroradiol, 2009, 15(3):316-324.
8. 杨树源, 只达石. 神经外科学[M]. 北京:人民卫生出版社, 2008:1104-1105.
9. 黄永谊. 显微镜下微创小骨窗法开颅治疗高血压脑出血效果观察[J]. 当代医学, 2010, 16(31):113.
10. 王建清, 陈衔城, 吴劲松, 等. 高血压脑出血手术时机的规范化研究[J]. 中国微侵袭神经外科杂志, 2003, 8(1):21-24.
11. 苏忠周, 周跃, 闰仁福, 等. 经侧裂-岛叶入路显微手术治疗脑出血基底节区脑出血[J]. 中华显微外科杂志, 2009, 32(5):427-429.
12. 汤秉洪, 覃宗明, 杨明彬, 等. 基底节区高血压脑出血手术治疗分析[J]. 华西医学, 2012, 27(5):677-680.
13. 盖延廷, 贾丕丰, 贺子建, 等. 小骨窗血肿清除术与微创血肿穿刺术治疗高血压脑出血的疗效比较[J]. 中华脑血管病杂志:电子版, 2010, 4(5):360-366.
14. 冯三平, 赵建华, 陈兴河, 等. 小骨窗经外侧裂-岛叶入路微创治疗基底节高血压脑出血[J]. 河北医药, 2011, 33(18):2759-2760.
15. Zuo Y, Cheng G, Gao DK, et al. Gross-total hematoma removal of hypertensive basal ganglia hemorrhages:a long-term follow-up[J]. J Neurol Sci, 2009, 287(1/2):100-104.
16. 马德年. 高血压脑出血术后再出血原因分析及对策[J]. 山东医药, 2010, 50(35):63-64.
17. 陈汉平, 刘丽萍, 叶晖, 等. 神经外科病人气管切开术的相关问题探讨[J]. 中国临床神经外科杂志, 2010, 15(2):112-113.

West China Medical Journal

Ultra-early Small Bone Window Craniotomy Operation for Hypertensive Cerebral Hemorrhage in Basal Ganglia Regions

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