Comparative Research On The Efficacy Of Transsylvian Approach And Temporal Approach For Hypertensive Basal Ganglia Hemorrhage

Objected:Hypertensive intracerebral hemorrhage (HICH) is a common and frequency cerebrovascular disease, with high rates of mortality and disability, poor prognosis. Basal ganglia area is the most common location. The typical clinical symptoms include disturbance of motor function and alteration of sensory perception and visual field defects. Appropriate surgical method to improve the prognosis is extremely important. The neurosurgical cleaning operation of intracranial hematoma for hypertensive basal ganglia hemorrhage (HBGH) mainly include the traditional temporal lobe cortex approach (TE) and the lateral fissure-insular approach (TR). By retrospective analysis of clinical data of these two groups of patients with HBGH in our hospital, who were performed evacuation operations of hematom with temporal lobe cortex approach or lateral fissure approach, the clinical effects and complications and prognosis of two surgical procedures were compared so as to provide help for clinic.Method:Retrospective analysis of clinical data of these two groups of patients with HBGH admitted in the neurosurgery department of our hospital from April2008to April2010, the clinical effects and complications and prognosis were compared between the two groups. The data were expressed as mean±standard deviation (SD). Statistical analysis was performed using SPSS Statistics17.0software. Student’s t test or one-way ANOVAs were performed to determine significant differences. The criterion for statistical significance was taken as P<0.05.Result:(1) There was no statistically differences in preoperative clinical data between the two groups.(2) Compared with temporal lobe approach group, the lateral fissure approach group (TR) had more merits, such as less time in surgery, higher rate of hematoma removal, fewer cases of decompressive craniectmy (P<0.05).(3) Both the GOS prognostic scores1month and Barthel indexs6months after operation in TR group were higher than the TE group’s (P<0.05);(4) TR group had more postoperative complications than TE group (P<0.05).Conclusion:Compared with traditional surgery via temporal lobe cortex, to remove hematoma via lateral fissure iapproach is more accordant with minimally invasive concept than that via temporal lobe codex approach, which can effectively improve the evacuation rate of hematoma and shorten the operating time and reduce complications.