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Objective To assess the clinical effect of lumboperitoneal shunting (LPS) on communicating hydrocephalus.Methods An retrospectively study was conducted on communicating hydrocephalus patients who were hospitalized from Sep.2009 and Dec.2013 at the No.174th Hospital of Chinese People's Liberation Army.All patients were underwent the LPS.All patients were with difference degrees of coma,and lumbar punctured for continued cerebrospinal fluid extended drainage before LPS.The change of disturbance of consciousness and the complications of LPS were assessed.Results There were 12 patients with communicating hydrocephalus.Of them,7 cases were underwent routine lumboperitoneal shunts,and 5 cases were experienced adjustment valve.After the LPS operation,3 patients were awakened from the coma,and 8 patients were improved in terms of consciousness and the decompression pressure of skull window as well as decreased enlarged lateral ventricles in pre-operation by CT.As for another 1 patient,the lumboperitoneal catheter had been slipped into the peritoneal cavity after 2 months of operation.There were no complications of infection,intracranial hemorrhages,obstruction of catheter and epilepsy.Conclusion The LPS should be the first selection of those patients who suffered from communicating hydrocephalus without trouble in spine and abdomen.A positive response to pre-operative continuing cerebrospinal fluid extend drainage is good prediction factor for surgical results of LPS.
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Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.
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Objective:To invetigate the value of a novel puncture and drainage of intracranial hematoma for the treatment of hypertensive intracerebral hemorrhage.Methods:In the group there were 27 patients with hypertensive intracerebral hemorrhage,with mean age of 61 years. Their hematomas located in thalamus(1 patient),basal ganglia(22 patients),and lobe(4 patients).The mean(SD)hematoma volume was 40(3.2)mL,the mean Glasgow Coma Scale (GCS)score was 10.15,and the mean National Institutes of Health Stroke Scale(NIHSS)score was 30.65 at admission.CT scan provided hematoma location.and the percutaneous puncture. grind and drainage were performed under the local anesthesia by using a novel puncture and drainage of intracranial hematoma.Results:No adverse events occurred during the punctures and after the procedures.One patiems died 20 days after procedure.Other patients were followed up for more than 6 months.Eight patients had a good outcome as assessed by Glasgow Outcome Scale(GOS)scores,15 had mild disability,2 had serious disability,and 1 was in a permanent vegetative state.Conclusions:This novel puncture and drainage of intracranial hematoma can be used in the treatment of hypertensive intracerebral hemorrhage,and it is simple and safe.
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Objective To discuss the experiences in successful treatment of hyperacute traumatic intracranial hematoma with percutaneous puncture and craniotomy.Methods Pereutaneous puncture and craniotomy was performed in 12 patients with hyperacute traumatic intracranial hematomas including seven with subdural hematoma,three with epidural hematoma and two with episubdural hematoma.Before operation,there found enlargement of bilateral pupil in six patients,enlargement of unilateral pupil in six and changed breathing rhythmicity in eight.Glasgow Coma Scale(GCS)was 3 points in four patients,4 points in six and 7 points in two.Results After pereutaneous puncture,enlarged pupil was retracted at different degrees in nine patients and spontaneous breathing conditions improved in seven.After crani otomy,two patients died within 24 hours,four died after 24 hours but six patients survived.The follow-up for 0.5-2 years showed four patients with sound Glasgow Outcome Score,two at vegetative state and six deaths.Conclusion Percutaneous puncture combined with craniotomy is an effective way for hyperacute intracranial hematoma.