Résumé
Objective To analyze the effect of minimally invasive puncture combined with continuous lumbar subarachnoid drainage in the treatment of thalamic expanding hematoma. Methods Seventy-eight patients with thalamic expanding hematoma admitted in our department from 2004 to 2008 underwent minimally invasive puncture combined with continuous lumbar subarachnoid drainage according to the size of intracranial hematoma and the involvement of the cerebral ventricles. Results Of the 78 cases, death occurred in 10 cases, with a mortality rate of 12.8%. The other 68 (87.2%) patients exhibited postoperative recovery of different degrees. Follow-up of the 68 patients for over 6 months after the operation showed that 30 patients had grade 1 Activity of Daily Living (ADL) with independence in daily living, 25 had grade 2 ADL (partially independent in daily living), 19 had grade 3 ADL (capable of assisted walking), 3 had grade 4 ADL (bedridden but conscious), and one patient had grade 5 ADL (in persistent vegetative state). Conclusion This combined treatment with individualized operations reduces the surgical trauma to the minimum and lowers the cost for effective elimination of the hematoma. This procedure also effectively lowers the intracranial pressures and promotes the neurological recovery of the patients with thalamic expanding hematoma.