| Objective: From studying the anatomy of the partial cortical sulci in frontal lobe and temporal lobe by using the heads of dead bodies we explore the therapeutic effects on cerebral hematomas in basal ganglia region via cortex or cortical sulci in order to reduce the postoperative complications of the patient with cerebral hemorrhage,and provide anatomical information for its clinical application.Methods:(1)To study the anatomy of partial cortical sulci in frontal lobe and temporal lobe we have used the heads of dead bodies.By expanding pterion craniotomy,Using Yasargil pterion approach we have measured the relevant data of the sulci.(2)From December 2013 to May 2015,106 patients were admitted to our hospitals withhypertensive basal ganglia hemorrhage.These patients were divided randomly intotwo groups;the patients in one of the groups were treated using the transcortical-sulcus approach,and those in the other group were treated using the traditional transcortical-transtemporal approach.The clinical data of 106 patients with hypertensive basal ganglia hemorrhage treated via transcortical-sulcus approach or traditional transcortical-transtemporal approach,51 patients with hypertensive basal ganglia hemorrhage treated via transcortical-sulcus approach and 55 patients with hypertensive basal ganglia hemorrhage treated via traditional transcortical-transtemporal approach were analyzed retrospectively.Results:(1)Anatomy:According to the location of the hematoma in the basal ganglia region.We selected sulcus frontalis inferior or superior temporal sulcus as a surgical approach.We measured the depth and the width of the relevant sulcus.The average depth of the left sulcus frontalis inferior is 20.37±1.10 mm and the right is 20.73±0.68 mm,There is no difference between them(P < 0.05).The average depth of the left superior temporal sulcus is 20.19±0.89 mm,while the right is 21.56±1.22 mm,There is also no difference between them(P < 0.05).(2)The 3-month efficacy rates of patients treated using the transcortical-sulcus and traditional cerebral cortex surgical approaches were 78.4% and 60%,respectively(P < 0.05).The incidence of epilepsy was lower in the transcortical-sulcus approach group compared with the traditional approach group,and significant differences were detected between the 2 groups(P < 0.05).Conclusions: It is feasible to treat intracerebral hematomas in basal ganglia region via cortical sulci near lateral fissure which is the natural fissure in the brain.The transcortical-sulcus approach can significantly improve the prognosis of patients with intracerebral hemorrhages in the basal ganglia and reduce the incidence of postoperative seizures. |
