Two Kinds Of Surgical Approach Of Early Removal On The Left Putamen Hemorrhage Study Of The Impact Of Language Function

Objective To analyze effect on sensory language function through the transsylvian - insula approach and through the transtemporal cortical approach on the left insula in the early removal of the hematoma in the left putamen.Methods According to the inclusion criteria (with a clear history of spontaneous hypertension; bleeding sites in the left putamen,;the amount of bleeding for the 30-70ml; disorders of consciousness:Ⅱlevel (GCS 13 points),Ⅲlevel (GCS 10-12 points); None surgical contraindications, followed up visit during hospitalization (1 month) and exclusion criteria (exclusion of aneurysm and arteriovenous malformation, tumor, traumatic hemorrhage; head CT examination identified the non-residual hematoma in 7days). 40 cases of left hypertensive putaminal hemotomas(HPH)were enrolled. All the cases were adopted surgical treatment in Second Hospital of Jilin University during October 2007 to October 2009. All the cases randomly divided into two groups: 20 cases received transcortical surgical treatment and 20 cases transsylvian - insular approach to remove thehematomas。All the cases were early followed -up in 1 month. Sensory language disorder of all the cases were evaluated after operation. The patient's age, hematoma volume, Glasgow coma scale were statistically analyzed, P> 0.05. Results: 40 patients with left putaminal hemotoma were selected in Second Hospital of Jilin University during October 2007 to October 2009 . All the patients were awake within 1 month, are at an early stage follow-up. There were 0 case with sensory aphasia in transsylvian - insula approach group. There were 13 cases with not complete sensory aphasia and 7 cases with complete sensory in transcortical. treatment group. The data were Statistically analyzed, P <0.05.Conclusion: The transsylvian - insula approach is superior to the transcortical approach in surgical treatment of left putaminal hematoma in regard to the impact of sensory language, so the transsylvian - insula approach should be first taken into account in the left putaminal hemotoma surgical treatment. Brain Pool - sylvian - insular approach. This approach dose little damage to the rear of left temporal lobe and has less impact upon the language function. The transsylvian - insula approach is worthy. However anatomy of the The transsylvian - insula approach is relatively complex and demanding surgeon familiar with the local anatomy, as well as to master the relatively skilled microsurgical techniques.