ABSTRACT
Objective The aim of our study was to examine the clinical value of neuroendoscopic surgery in hypertensive cerebellar hemorrhage.Methods The clinical data from 38 patients with cerebellar hemorrhage were retrospectively analyzed.Thirty-eight patients included 18 cases with neuroendoscopic hematoma evacuation (neuroendoscopic group) and 20 cases with craniotomy hematoma evacuation (craniotomy group).The perioperative parameters and clinical outcome were statistically analyzed.Results Compared with craniotomy group,the mean operative time was shorter [(82.9±17.0)min vs.(177.9±28.8)min,t=12.545,P=0.000],the loss of mean blood volume was smaller [(45.1±15.6)mL vs.(197.9±29.5)mL,t=20.237,P=0.000]ml,ventricle drainage time [(3.5±1.5)d vs.(5.3±1.4)d,t=3.751,P=0.001],ICU stay time [(2.9±1.0)d vs.(4.7±1.5)d,t=4.146,P=0.000] and hospital stay time [(7.4±1.5)d vs.(9.9±2.8)d,t=3.348,P=0.002] were shorter (P＜0.05).Two weeks after surgery,1 cases died in neuroendoscopic group and 2 cases died in craniotomy group (P=1.000,P＞0.05).Three months after surgery,GOSE was greater than 4 in 14 cases in neuroendoscopic group and in 13 cases in craniotomy group and the difference was not significant (2=0.752,P=0.386,P＞0.05).Conclusion Although there are no differences in mortality and clinical outcomes between neuroendoscopic hematoma evacuation and occipital craniotomy hematoma evacuation for hypertensive cerebellar hemorrhage patients,neuroendoscopic hematoma evacuation can significantly reduce the mean operative time,the loss of mean blood volume,ventricle drainage time,ICU stay time and hospital stay time.Thus,neuroendoscopic hematoma evacuation in hypertensive cerebellar hemorrhage is safe and effective,which has a great value of application in the future.
ABSTRACT
Objective The aim of our study was to examine the clinical value of neuroendoscopic surgery in hypertensive cerebellar hemorrhage.Methods The clinical data from 38 patients with cerebellar hemorrhage were retrospectively analyzed.Thirty-eight patients included 18 cases with neuroendoscopic hematoma evacuation (neuroendoscopic group) and 20 cases with craniotomy hematoma evacuation (craniotomy group).The perioperative parameters and clinical outcome were statistically analyzed.Results Compared with craniotomy group,the mean operative time was shorter [(82.9±17.0)min vs.(177.9±28.8)min,t=12.545,P=0.000],the loss of mean blood volume was smaller [(45.1±15.6)mL vs.(197.9±29.5)mL,t=20.237,P=0.000]ml,ventricle drainage time [(3.5±1.5)d vs.(5.3±1.4)d,t=3.751,P=0.001],ICU stay time [(2.9±1.0)d vs.(4.7±1.5)d,t=4.146,P=0.000] and hospital stay time [(7.4±1.5)d vs.(9.9±2.8)d,t=3.348,P=0.002] were shorter (P＜0.05).Two weeks after surgery,1 cases died in neuroendoscopic group and 2 cases died in craniotomy group (P=1.000,P＞0.05).Three months after surgery,GOSE was greater than 4 in 14 cases in neuroendoscopic group and in 13 cases in craniotomy group and the difference was not significant (2=0.752,P=0.386,P＞0.05).Conclusion Although there are no differences in mortality and clinical outcomes between neuroendoscopic hematoma evacuation and occipital craniotomy hematoma evacuation for hypertensive cerebellar hemorrhage patients,neuroendoscopic hematoma evacuation can significantly reduce the mean operative time,the loss of mean blood volume,ventricle drainage time,ICU stay time and hospital stay time.Thus,neuroendoscopic hematoma evacuation in hypertensive cerebellar hemorrhage is safe and effective,which has a great value of application in the future.
ABSTRACT
Hypertensive cerebellar hemorrhage was rarely diagnosed in the past and therefore thought to be infrequent, but after the introduction of computerized tomography(CT) scans it has been more commonly diagnosed. We present 36 patients with hypertensive cerebellar hemorrhage who were treated in our hospital from June 1989 to January 1994. There were 15 men and 21 women, with ages ranging between 34 and 91 years. The volume of cerebellar hematoma and the grade of quadrigeminal cisternal obliteration on CT scans significantly correlated to the level of consciousness at admission. Several prognostic factors which might influence the outcome were statistically analysed:the level of consciousness at admission, the volume of hematoma, the treatment modality, the presence of hydrocephalus, the presence of quadrigeminal cisternal obliteration on CT scans, and the location of hematoma. Overall mortality rate was 13.9% and many of the above factors affected the outcome except for the treatment modality and the presence of hydrocephalus. The outcome in patients with GCS scores of 14 or 15 at admission was excellent. We conclude that the level of consciousness at admission is the most important prognostic factor and surgical decompression is indicated particularly in patients with an impaired level of consciousness, provided that brainstem reflexes are still intact. An accurate monitoring of the patient's clinical status is very important since its worsening is an absolute indication for surgery independent of the size of hematoma.