高血压基底节区中少量出血早期手术治疗

Abstract

Objective: To evaluate the efficacy of operative approach via lateral fissure in hypertensive basal ganglia hemorrhage with bleeding volume 20～30ml during early period. Methods: A total of 33 patients with hypertensive basal ganglia hemorrhage underwent microsurgical treatment transsylvian-transinsular approach within 24 hours after stroke. All the patients had definite neurological dysfunction and the blooding volume 20～30ml. The remained hematoma volume after 24 hours, the efficacy after 2 weeks, and activity of Daily Living after 6 months were measured to be compared between the two groups. Results: 24 hours after operation, hematoma was evacuated more than 90% in 27 cases, 70% in 3 cases. 2 weeks after surgical operation, 26 cases got remarkably effect and 5 cases turned better. Follow-up assessment according to the Activity of Daily Living (ADL) for 6 months revealed a good recovery of grade I in 8 cases, grade II in 17,grade III in 5, grade IV in 1. Conclusion: Microsurgical treatment transsylvian-transinsular approach has a significant therapeutic effect on hypertensive basal ganglia hemorrhage of 20～30ml hematoma cases with definite neurological dysfunction. Key WordsHypertensive cerebral hemorrhage; Basal ganglia hematoma; Transsylvian-transinsular approach