Surgical Treatment for Primary Brainstem Hemorrhage to Improve Postoperative Functional Outcomes.
World Neurosurg
; 120: e1289-e1294, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30244074
ABSTRACT
BACKGROUND:
It remains controversial whether primary brainstem hemorrhage (PBH) should be managed conservatively or treated promptly by surgical evacuation of the hematoma. In the present study, we discuss 5 cases of PBH that were treated surgically and the ability of surgical management to improve postoperative functional outcomes.METHODS:
The 4 patients with pontine and medullary hemorrhage underwent surgery via the lateral or midline suboccipital and trans-rhomboid fossa approach in the half-sitting position. The patient with a midbrain hemorrhage underwent surgery via the subtemporal approach in the supine lateral position. We analyzed the postoperative functional outcomes 1 week after surgery and the modified Rankin scale scores 6 months after discharge.RESULTS:
Three patients with disturbance of consciousness experienced improvement in their level of consciousness. Four patients with hemiparesis improved in motor function. Oculomotor nerve function improved in 2 of 3 cases. Facial nerve function improved in 2 of 2 cases. Spontaneous respiration improved in 1 patient. The postoperative modified Rankin scale scores improved in all 5 cases.CONCLUSIONS:
Because of the good results with these 5 patients with PBH, this surgical strategy could be encouraged with exclusion criteria for early initiation of rehabilitation strategies. We hope to increase our number of patients to accumulate further evidence.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Tronco Encefálico
/
Hemorragias Intracranianas
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article