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

Video：

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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. 鄔東曉, 張俊義, 王建軍, 等. 高血壓腦出血的外科治療體會[J]. 內蒙古民族大學學報, 2009, 7(5):90-91.
2. 王忠誠. 神經外科學[M]. 武漢:湖北科學技術出版社, 1998:687.
3. 附鵬程, 陳繼華, 夏明萬, 等. ImagJ測量顱內血腫體積與多田公式的比較評價[J]. 海南醫學, 2011, 22(5):75-77.
4. 董偉, 蔡可勝, 朱守明. 經外側裂入路顯微手術治療高血壓性基底節區腦出血32例[J]. 中國臨床神經外科雜志, 2012, 17(7):428-430.
5. 陳卉. 小骨窗開顱術治療中等量基底節區高血壓腦出血的臨床療效[J]. 四川醫學, 2012, 33(11):1950-1952.
6. 游潮. 李浩.進一步重視和規范高血壓腦出血的外科治療[J]. 中華神經外科雜志, 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. 楊樹源, 只達石. 神經外科學[M]. 北京:人民衛生出版社, 2008:1104-1105.
9. 黃永誼. 顯微鏡下微創小骨窗法開顱治療高血壓腦出血效果觀察[J]. 當代醫學, 2010, 16(31):113.
10. 王建清, 陳銜城, 吳勁松, 等. 高血壓腦出血手術時機的規范化研究[J]. 中國微侵襲神經外科雜志, 2003, 8(1):21-24.
11. 蘇忠周, 周躍, 閏仁福, 等. 經側裂-島葉入路顯微手術治療腦出血基底節區腦出血[J]. 中華顯微外科雜志, 2009, 32(5):427-429.
12. 湯秉洪, 覃宗明, 楊明彬, 等. 基底節區高血壓腦出血手術治療分析[J]. 華西醫學, 2012, 27(5):677-680.
13. 蓋延廷, 賈丕豐, 賀子建, 等. 小骨窗血腫清除術與微創血腫穿刺術治療高血壓腦出血的療效比較[J]. 中華腦血管病雜志:電子版, 2010, 4(5):360-366.
14. 馮三平, 趙建華, 陳興河, 等. 小骨窗經外側裂-島葉入路微創治療基底節高血壓腦出血[J]. 河北醫藥, 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. 馬德年. 高血壓腦出血術后再出血原因分析及對策[J]. 山東醫藥, 2010, 50(35):63-64.
17. 陳漢平, 劉麗萍, 葉暉, 等. 神經外科病人氣管切開術的相關問題探討[J]. 中國臨床神經外科雜志, 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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