Microsurgical treatment for hypertensive large basal ganglia hemorrhage

Objective To investigate the methods and curative effect of microsurgical treatment for hypertensive large basal ganglia hemorrhage.Methods By means of trans-pterion or trans-revised pterion craniotomy and large decompressive craniotomies,transsylvian-transinsular approach is made necessarily by minimally invasive technique,removing intracranial hematoma and withholding bleeding under microscope for 60 patients of hypertensive basal ganglia hemorrhage.Then follow-up for 6—24 months after the operation,clinical outcome and prognosis were evaluated by Modified Rankin Scale(MRS).Results Five patients died among 60 cases,mortality was 7.1%. None of patients had no symptoms at all(MRS=0),l patient had no significant disability despite symptoms(MRS=l),2 patients had slight disability(MRS=2),19 patients had moderate disability (MRS = 3 ),25 patients had moderately severe disability(MRS = 4 ),8 patients had severe disability(MRS = 5 ).Conclusions Trans-pterion or trans-revised pterion craniotomy,large decompressive craniotomies were necessary,transsylvian-transinsular approach was made by minimally invasive technique,so as to remove intracranial hematoma and withhold bleeding under microscope for hypertensive basal ganglia hemorrhage complicated with cerebral herniation may be advocated.