摘要
Abstract
Objective To observe the curative effect of microsurgery through cerebellar medullary fissure approach in the treatment of cerebellar hemorrhage into ventricles of the brain. Method Retrospectively analyzed the clinical data and follow-up data of 94 patients who were diagnosed as cerebellar hemorrhage into ventricles of the brain from June 2013 to June 2016 in Tangdu Hospital of the Fourth Military Medical University. After reviewing the related literatures, the clinical characteristics and the key points of diagnosis and treatment were discussed. Result As shown by CT scanning, hemotomas were totally removed by microsurgery in 79 cases, and subtotally removed in 15 cases. Postoperatively, there were 5 cases of rehaemorrhagia; 21 case of pneumonia received tracheotomy, and tracheal tubes in 17 cases were successfully removed at the end of the follow-up. 6 months after surgery, outcome was determined according to the Glasgow outcome scale (GOS), which showed that 64 cases (68.1%) achieved good recovery, 12 cases (12.8%) were moderately disabled, 6 cases (6.4%) were severely disabled, 4 cases (4.3%) were vegetatively survived and 8 cases (8.5%) died. Various complications occurred in 82 survival cases except patients in vegetative status, included 66 cases of nausea/vomit, 17 cases of dizziness, 11 cases of ataxia, 14 cases of hearing loss, 8 cases of nystagmus, 4 cases of choking, 3 cases of upper gastrointestinal bleeding, 2 cases of lower extremity deep venous thrombosis,4 cases of cerebellar mutism syndrome. Cure or improvement occurred in most of cases after symptomatic treatment. Conclusion The fourth ventriclehematoma caused by cerebellar hemorrhage can be effectively evacuated by microsurgery through cerebellar medullary fissure approach, and which can improve cerebrospinal fluid circulation, reduce intracranial pressure, prevent brain damage and thereby protect important brainareas with less postoperative complications.关键词
小脑出血/第四脑室/小脑延髓裂/显微手术Key words
Cerebellar hemorrhage/Fourth ventricle/Cerebellomedullary fissure/Microsurgery
