The Effect Of Neuronavigation Puncture Hematoma Removal And MRI Nerve Conduction Beam Imaging On The Recovery Of HPH Motor Function

Part One: Effects of Transsylvian-Transinsular Approach to Hypertensive Putaminal Hematoma Operation on Motor RecoveryObjective: To explore function recovery effect of microsurgical treatment on patients with hypertensive putaminal hematomas(HPH)through transsylvian transinsular approach.Methods: Retrospective analysis of 120 HPH patients which were divided into two groups at random,the experimental group underwent the transsylvian transinsular approach,and the controlled group with routine temporal lobe craniotomy.We compared the improvement of limbs movement and activities of daily living with simplified Fugl-Meyer assessment and Barthel index.Results: Intra-group comparison: the FMA value and Barthel index in experimental group have significant difference pre-and postoperation(P<0.05),while in control group have no significant difference(P>0.05).Intergroup comparison: FMA value and Barthel index have no significant difference pre-operation between the two groups while in 4 weeks the difference is significant.Conclusion: The transsylvian transinsular approach to HPH has the advantages of hematoma clearing thoroughly and can significantly improve motor recovery.Part Two: Effects of Neuronavigation-assisted aspiration to Hypertensive Putaminal Hematoma Operation on Motor RecoveryObjective: To study the effects of neuronavigation on the function recovery effect of HPH.Methods: 100 HPH patients which were in accordance with the inclusive criteria were divided into two groups at random,the experimental group undewent neuronavigation guidance minimally invasive approach,and the controlled group with routine temporal lobe craniotomy.Results: The FMA values and BI of motor assessment scale in experimental group was superior to control group in 3 months post-operation.Conclusion: The neuronavigation guidance minimally invasive approach is prior to routine craniotomy in the motor recovery.Part Three: Effects of Neuronavigation-assisted aspiration guided by diffusion tensor imaging and diffusion tensor tractography to HPH Motor RecoveryObjective: To investigate diffusion tensor tractography on the pre-operation plan and post-operation function evaluate of hypertensive putaminal hematomas.Methods: We carried on magnetic diffusion tensor imaging scanning to 20 cases of HPH patients,and acquire the three-dimensional tractography fibers imaging,show the spatial relation between fibers and hematoma,which guide neuronavigation aspiration safely.We compared the KPS valued pre-and post-operation in order to evaluate the function influence.We compared the change of FA value in corticospinal tract of affected side,calculate the correlation between the two in order to investigate the guidance of FA value in prognosis evaluation.Results: The muscle force and average value of KPS were improved obviously post-operativly.The FA values and KPS values were positive correlation.Conclusion: The operation method which combine the diffusion tensor tractography and neuronavigation guidance can significantly improve HPH motor recovery.