ABSTRACT
Two hundred and twenty patients with hypertensive basal ganglia hemorrhage (HBGH)undergoing cranial drilling operation and placement of soft catheter for drainage were enrolled.Among all patiems,the operation was performed at ≤6 h of disease onset in 92 cases (ultra-early group),6-24 h in 74 cases (early group) and ＞ 24 h in 54 cases (selective group).The surgery-related complications,nearterm outcome and long-term outcome were compared among three groups.In ultra-early group,recurrent hemorrhage was observed in 26 cases (28％),which was higher than that in other two groups.In selective group,there were 11 cases (20 ％) of well recovered,19 cases (35％) of moderate deformity,16 cases (30％) of severe deformity,5 cases(9％) of vegetative state and 3 fatal cases(6％) indicating that the nearterm outcome was worse than those other two groups.However there was no significant difference in longterm outcome among three groups.The rapid minimal invasive cranial drilling and soft catheter drainage is a safe and effective operation for HBGH patients and the optimal time for operation is 6-24 hours.
ABSTRACT
Objective To investigate the value of electromagnetic navigation in microsurgical resection of intracranial cavernous hemangioma of different locations.Methods The microsurgical resection of intracranial cavernous hemangioma of different locations with the guide of electromagnetic navigation of COMPASS Cygnus system,There were 47 cavernous hemangioma of 43 patients,including of multiple cavernous hemangioma of 3 cases,one case had 3,the other 2 cases had 2 ; Including 25 deep in the cerebral cortex(including of 4 deep in the cerebellar cortex),twenty shallow in the cerebral cortex,two were in the orbital apex,including of 4 deep in the sensorimotor cortex,four deep in the language center,and 2 deep in the visual center.Results All 47 cavernous hemangioma of 43 patients,the accuracy was 100％.The resection rate was 100％,including of 16 patients were removed with a straight incision.There was no one with the neurological dysfunction worse postoperative,with no deaths,with 1 case of normal perfusion pressure breakthrough and was cured by conservative treatment.Thirty cases were discharged within 1 week.The blood loss of 30 cases was less than 50 ml.The average registration error of navigation was 1.6 ± 0.4 mm.Conclusion The surgical incision and surgical approach can been designed with the help of electromagnetic navigation system before operation,and can accurately resect the lesions simultaneously avoid brain function area,protect the normal brain tissue,reduce postoperative complications,with the help of the electromagnetic navigation system intraoperative in real time.It is suitable for minimally invasive surgery for intracranial cavernous hemangioma.