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Objective To explore treatment methods and prognosis of external ventricular drainage .Methods A retrospective analysis of 66 cases with severe intraventricular hemorrhage patients were selected ,36 cases underwent bilateral ventricle drainage and urokinase ( UK ) intraventricular fibrinolysis therapy +terminal cistern drainages , 30 cases with bilateral ventricle drainage and urokinase for intraventricular fibrinolysis .The prognosis of the patients with modified Rankin Scale score was assessed .After multiple cerebral CT examination hematoma imaging changes were observed.Results A group of intraventricular hemorrhage clearing time (5.3 ±1.5)d,B group of intraventricu-lar hemorrhage clearing time (8.2 ±2.5)d,there was significant difference (t=-5.820,P=0.000).Rate in group A was 83.3%(30/36),group B was 66.7%(20/30), there was no significant difference (χ2 =2.475,P=0.116). Conclusion This study suggests that intraventricular hemorrhage were given bilateral ventricle drainage and uroki -nase for intraventricular fibrinolysis therapy +terminal cistern drainages effect is better .
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Objective To evaluate the clinical value of endovascular embolization in the treatment of intracranial aneurysm.Methods 41 patients with 46 intracranial aneurysms were treated by endovascular embolization with different treatment protocols and the clinical data were analyzed.Results Intracranial aneurysms were embolized with detachable coil in 33 patients with 38 aneurysms,rupture of aneurysm occurred during the operation in 1 patient.Seven patients with 7 aneurysms were treated with intraeranial covered stentand,no nerve dysfunction occurred.One patient with 1 aneurysm was embolized by parent artery,no occlusion nerve dysfunction occurred.Conclusion Endovascular treatment is a minimally invasive,safe and effective technique for treating intracranial aneurysms.
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ObjectiveTo review the experience with surgical removal of meningiomas in the falx cerebri and sagittal sinuses.MethodsThirteen patients with meningiomas in the falx cerebri and sagittal sinuses were retrospectively analyzed.ResultsTumors in eleven patients were totally removed( Simpson Grade Ⅰ and Ⅱ ),while in two patients they were subtotally resected( Simpson Grade Ⅲ and Ⅳ ).After operations,no patient died.ConclusionAdequate surgical exposure,efficient management of operative bleeding,protection and replacement of the sagittalsinus,and avoidence of damage to the brain tissues were the key factors to improve operative effect.
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Objective To discuss the clinical feature, diagnostic main points and treatment of diffuse axonal injury(DAI). Methods The clinical materials and imaging findings and treatment and prognosis of 48 cases with DM were analyzed retrospectively. Results 18 cases showed a good outcome, while 12 were moderately disabled, 10 severely disabled or survived in a permanent vegetative state and 8 cases died. Conclusion To preserve the fluent respiratory tract, to control intracranial pressure, to treat with hyperbaric oxygenation and high-dose naloxone in early time were crucial in clinical practice to DAI.
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Objective To study the role of hemorrhagic shock in severe eraniocerebral trauma with stress ulcer.Methods The clinical data of 428 patients of sevcere craniocerebral tramna in 0111"hospital from January 2001 to January 2009 were divided into two groups according to whether or not merging with hemorrhagic shock.The incidence of stress ulcer in two groups was calculated and the PH ofgastric juice and blood in different periods were measured.Results Stress ulcerdevelopedin 56.4%(75/133)ofpatientswith hemorrhagic shockand 12.5%(37/295)of patients with hemorrhagic shock-free,with significant difference between the two groups(P＜0.01).Blood pH differed significantly(P＜0.01)on 2d,but not on 7d(P＞0.05)after injury between the two groups.There wag no significant difference in gastric juice pH on 2d and 7d after injury between the two groups(P＞0.05).Condusion Hemorrhagie shock phys an important role in severe craniocerebral trauma with stress deer.
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Objective To explore the significance, indicatinos and complications of emergency tracheotomy for patients with severe craniocerbral trauma. Methods The clinical data of 42 patients with severe craniocerbral trauma were retrospectively analyzed. Results Of them, 20 were basically cured (48%), 12 had improvement (29%) ,3 were released from the hospital(7 % ), 1 survived(2 % ) in a vegetative state,and 6 died(14%). Conclu- sion Emergent tracheotomy should be performed on patients with severe craniocerbral trauma to resolve respiratory tract obstruction, improve air current, prevent cerebral anoxia, prevent and treat pulmonary infection, increase the therapeutic efficacy.
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Objective To explore the measures to prevent acute encephalocele during the decompressive craniotomy in the patients with severe brain injury.Methods The clinical data of 28 patients with severe brain injury,who were treated by extended fronto-temporo-prietal craniotomy were analyzed retrospectively.The sequential dural ineision(SDI)was performed during the operation in all the patients.Results The catastrophic encephalocele did not occur in all the cases even if very hish intracranial pressure wag caused by fulminant brain swelling in some cases.The total removal of hematomas was achieved in 19 cases,but there still was extensive hemorrhage in the operative fieId in 4 eases and secondary intracranial hematomas in the other regions in 5 cases observed on postoperative CT scan.The disappeared basal cistern and the third ventricle could be observed again in 12 eases.According to GOS,9 patienm obrained good recovery,5 was moderately disabled,4 were severely disabled,2 vegetatively survived,and 8 died.Condusion The encephalocele,which is easily produced by rapid decompression,is prevented by eontrollable decompression as early as possible and SDI in the patients with especially severe brain injury.