Analysis On The Surgical Treatment And Curative Effect Of Thalamic Hemorrhage Broking Into Ventricles

【Objective】 To investigate the indications and the clinical effect on thalamic hemorrhage broking into ventricles due to two ways of surgical operation, that treated only by external ventricular drainage or treated by evacuation of hematoma through Interhemispheric-callosum approach.【Methods】 A retrospective analysis had been made of 38 surgical patients with thalamic hemorrhage broking into ventricles, the 38 patients got complete clinical data, of which 25 cases were treated only by external ventricular drainage, 13 cases by evacuation of hematoma through Interhemispheric-callosum approach. All the patients went through a 3 months to 1 year follow-up and made Clinical prognosis evaluation by Activity of Daily Living(ADL).【Results】 The statistics were made by different surgical techniques, of 25 patients who were treated only by external ventricular drainage, 5 cases were classified as grade I, 8 cases as grade II, 3 cases as grade III, 5 cases as grade IV and 4 cases died. The mortality rate was 16%. Three out of four deceased patients died of intracranial infection, and one died of pulmonary infection combined with multiple organ dysfunction; Of 13 patients who were treated by evacuation of hematoma through Interhemispheric-callosum approach + external ventricular drainage, 2 cases as grade II, 2 cases as grade III, 4 cases as grade IV and 5 cases died. The mortality rate was 38.5%. Four out of five deceased patients died of pulmonary infection combined with multiple organ dysfunction, and one died of intracranial rebleeding.【Conclusion】 Single external ventricular drainage took obvious curative effect for the patients who got less than 30 ml bleeding volume in thalamic hemorrhage and only broken into one-side ventricle or patients with disturbance of consciousness was light, that the GCS score got over 8 points.But for the patients who got more than 30 ml bleeding volume and ruptured into the lateral ventricles in thalamic hemorrhage or lead to intraventricular hemorrhage,also as to patients who got less than 30 ml bleeding volume,but heavier disturbance of consciousness, the GCS score got less than 8 points, the evacuation of hematoma through Interhemispheric-callosum approach drainage had more advantages.