Abstract:
Objective To investigate the effect of keyhole microscopic craniotomy via lateral fissure in treatment of hypertensive intracerebral hemorrhage (HICH) in basal ganglia in ultra-early stage.
Methods A total of 85 patients with HICH in basal ganglia were treated with keyhole microscopic craniotomy via lateral fissure in ultra-early stage (within 6 hours after onset). Immediately and within 48 hours after operation, cranial CT were re-examined to understand the clearance status of hematoma. At 6 months of follow-up, the prognosis was evaluated by Activity of Daily Living (ADL) grading.
Results Hematoma clearance volume greater than 80% of total volume was observed in 64 cases (75.3%). The patients were followed up for 6 months, and the ADL classification result included grade Ⅰ in 13 cases (15.3%), grade Ⅱ in 37 cases (43.5%), grade Ⅲ in 25 cases (29.4%), grade Ⅳ in 5 cases (5.9%), and grade V in 3 cases (3.5%). Two patients died of postoperative complications (2.3%).
Conclusion Keyhole microscopic craniotomy via lateral fissure in ultra-early stage has the advantages of less trauma, good intraoperative exposure and complete hemostasis, which is especially suitable for patients with moderate bleeding in the basal ganglia, and it can promote the recovery of neurological function in the later stage.
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