Minimally invasive treatment for hypertensive intracerebral hemorrhage through a straight incision and keyhole craniotomy / 中国微创外科杂志

ABSTRACT

Objective To evaluate the effect of surgical treatment of hypertensive intracerebral hemorrhage (HICH) through a straight incision and keyhole minimally invasive craniotomy. Methods According to the location of the hematoma revealed by preoperative CT scans, a straight skin incision was made 4～5 cm in length, and then a keyhole craniotomy 2 cm in diameter was performed. The underlying cortex was incised the hematoma was exposed and removed under microscope. Results The hematomas were thoroughly cleared in 17 cases. The clearance rate was 90% in 18 cases and 80% in 4 cases. Re-hemorrhage occurred in 2 cases after operation. A total of 35 cases was followed for 0.5～3 years (mean, 2.1 years). The quality of life was assessed by activity of daily living (ADL) classification, which revealed 9 cases of grade 1, 12 cases of grade 2, 9 cases of grade 3, 4 cases of grade 4, and 1 case of grade 5 at the 6th postoperative month. The mortality of this series was 10.3% (4/39). Conclusions Straight incision keyhole minimally invasive craniotomy is a rapid, effective, and safe technique for the removal of hypertensive cerebral hemorrhage. The method herein provides an effective decompression of hematoma, with low recurrence rate and good prognosis compared with conventional surgery.