Transsylvian-transinsular approach for the removal of basal ganglia hemorrhage under a Modified Intracerebral Hemorrhage score
| Autor: | Wen-Yuan Lee, Chao Hsuan Chen, Der Yang Cho, Hao Che Chuang, Chun Chung Chen, Ya I. Huang, Han Chung Lee, Yen Tse Chu |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Microsurgery Cause of Death Medicine Humans Minimally Invasive Surgical Procedures Glasgow Coma Scale Antihypertensive Agents Cause of death Aged Retrospective Studies Intracerebral hemorrhage Aged 80 and over Cerebral Cortex business.industry Dissection Basal Ganglia Hemorrhage Cerebral Aqueduct Retrospective cohort study General Medicine Recovery of Function Middle Aged Functional recovery medicine.disease Single surgeon Surgery Otorhinolaryngology Invasive surgery Hypertension Female Intracranial Hypertension Safety business Tomography X-Ray Computed Basal ganglia hemorrhage Craniotomy Follow-Up Studies Hydrocephalus |
| Zdroj: | The Journal of craniofacial surgery. 24(4) |
| ISSN: | 1536-3732 |
| Popis: | BACKGROUND Spontaneous intracerebral hemorrhages account for 20% of all strokes. The Modified Intracerebral Hemorrhage (MICH) score provides a simple, reliable system for decision making regarding surgical treatment. The transsylvian-transinsular approach had previously been neglected because of the dependence on great surgical experience. We believe this approach not only compares favorably with the minimally invasive surgery concept but also preserves most of the cerebral functional cortex with a maximum hematoma evacuation rate. METHODS From May 2007 to September 2008, a single surgeon treated 32 patients with basal ganglia hemorrhage using the transsylvian-transinsular approach. Of these, 20 had MICH scores of 2 to 3; 5 had MICH scores of 4; and 7 had MICH scores of 5. After 24 postoperative hours, we evaluated the hematoma evacuation rate by a computed tomography scan. The functional recovery was evaluated by the Barthel Index at 1, 3, and 6 months postoperatively. RESULTS All data were analyzed according to MICH score. The hematoma evacuation rates were in the following order: MICH scores 2 to 3 (97%) > MICH score 4 (92%) > MICH score 5 (90%). Surgery-related mortality was MICH2, 3 (0%) < MICH4 (20%) < MICH5 (43%). The Barthel Index of the MICH2, 3 patients (n = 18) improved from 16.9 at 1 postoperative month to 41.94 at 6 postoperative months. CONCLUSIONS The transsylvian-transinsular approach for the removal of an ICH was not difficult, and it was found to be a safe method for treating a spontaneous basal ganglion ICH. In addition, this approach conformed with the spirit of minimally invasive surgery. |
| Databáze: | OpenAIRE |
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