Microsurgical Treatment Of Hypertensive Putamen Hemorrhage Through Lateral Fissure Approach Under The Guidance Of CT Angiography

Objective:This study was conducted to investigate the result of microsurgicaltreatment of hypertensive putamen hemorrhage through lateral fissureapproach assisted by CT angiography.Methods:Between May2004and May2008,81cases with hypertensiveputamen hemorrhage were treated,divided into CTA assisted throughlateral fissure approach of hematoma group (58cases), and the traditionof the superior temporal gyrus approach to treatment group (23cases).Results of the treatment for these cases were analyzed to summarizethe experience.Results:The prognoses were assessed according to Karnofsky performancescale (KPS) and the clinical follow-up period is half a year. CTA assistedlateral fissure treatment group of58cases:15(25.9%) were60-80scores of KPS,20(34.5%) was40-50scores of KPS,20(34.5%) was10-30scores of KPS,3(5.1%) was0scores of KPS (death); thetraditional superior temporal gyrus approach23cases in the treatment group of1cases:1(4.4%) were60-80scores of KPS,5(21.7%) was40-50scores of KPS,15(65.2%) was10-30scores of KPS,2(8.7%)was0scores of KPS. Conclusion CTA assisted through lateral fissureapproach microsurgery treatment of hypertensive putaminal hemorrhagetreatment is better than the traditional approach in the treatment of thesuperior temporal gyrus.Conclusion:1.Preoperative CTA, help identify hypertensive hemorrhage andother non-hypertensive intracerebral hemorrhage (such as arteriovenousmalformations), to reduce the blind surgically induced uncontrollableintraoperative bleeding.2. CTA can be fully assessed in the preoperative cerebral artery andcentral branch anatomical relationship with the hematoma, choose fromthe insular cortex nearest isolated lateral fissure, reduce intraoperativeinjury.3. Microsurgical Treatment of Hypertensive Putamen Hemorrhagethrough Lateral Fissure Approach under the Guidance of CTangiography is better than the traditional approach by treating thesuperior temporal gyrus, is an effective and worthy of promotion surgicalmethods.