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Analysis on Emergency Microsurgical Treatment for Cerebral Hernia Caused by Intracranial Anterior Circulation Aneurysm with Intracranial Hematoma
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作者 Gang Yang Junjie Lv +4 位作者 Shaojun Yang Chao Gu Chenbing Wang Lulu Weng Feng Ding 《Open Journal of Emergency Medicine》 2021年第3期49-59,共11页
<b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:""><span style="font-family:Verdana;">: This study is to discus... <b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:""><span style="font-family:Verdana;">: This study is to discuss CT performances and direct surgical strategy as well as therapeutic effect of patients who have rupture hemorrhage of intracranial anterior circulation aneurysm with complications of intracranial hematoma and cerebral hernia. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: CT performances and treatment of 14 patients who have rupture hemorrhage of intracranial anterior circulation aneurysm with complications of intracranial hematoma and cerebral hernia in our hospital from March, 2019 to March, 2021 were reviewed. The relationship between hematoma caused by intracranial anterior circulation aneurysm and position of the aneurysm was analyzed. Besides, surgical</span><span><span style="font-family:Verdana;"> processing keys were discussed. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: For all selected patients</span></span><span style="font-family:Verdana;">, intracranial hemorrhage is proved to be caused by rupture of aneurysm. Among them, there are 2 cases of anterior communicating aneurysms, 3 cases of posterior communicating aneurysms, and 9 cases of middle cerebral aneurysms.</span><span style="font-family:Verdana;"> According to exploration, we found 1 case of multiple </span><span style="font-family:Verdana;">aneurysm, which is the combination of a middle cerebral aneurysm (the responsible aneurysm) and ipsilateral posterior communicating aneurysm. There were two cases of intraoperative rupture. In this study, 3 patients died. According to GOS grading at 3 months after the operation, there were 1 case of V-grade (good recovery), 3 cases of IV-grade (self-maintenance), 5 cases of III-grade (severe disabled), 2 cases of II-grade (persistent vegetative state) and 3 cases of I-grade (died). </span><b><span style="font-family:Verdana;">Conclusions</span></b><span style="font-family:Verdana;">: Emergency microsurgical treatment can lower </span><span style="font-family:Verdana;">the death rate of cerebral hernia caused by intracranial </span><span style="font-family:Verdana;">anterior circulation aneurysm with intracranial hematoma and recover the neurological functions to the maximum extent. 展开更多
关键词 Anterior Circulation Aneurysm Intracranial Hematoma cerebral hernia MICROSURGERY
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The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude 被引量:15
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作者 Lin-Jie Wei Chi Lin +9 位作者 Xing-Sen Xue Guo-Dong Dun Jian-Bo Zhang Yan-Xiang Tong Jia-Xiong Wang Shi-Ji Yang Ling Wang Zhi Chen Hua Feng Gang Zhu 《Chinese Journal of Traumatology》 CAS CSCD 2021年第6期328-332,共5页
Purpose:Rapid decompressive craniectomy(DC)was the most effective method for the treatment of hypertensive intracerebral hemorrhage(HICH)with cerebral hernia,but the mortality and disability rate is still high.We susp... Purpose:Rapid decompressive craniectomy(DC)was the most effective method for the treatment of hypertensive intracerebral hemorrhage(HICH)with cerebral hernia,but the mortality and disability rate is still high.We suspected that hematoma puncture drainage(PD)+DC may improve the therapeutic effect and thus compared the combined surgery with DC alone.Methods:From December 2013 to July 2019,patients with HICH from Linzhi,Tibet and Honghe,Yunnan Province were retrospectively analyzed.The selection criteria were as follows:(1)altitude≥1500 m;(2)HICH patients with cerebral hernia;(3)Glascow coma scale score of 4-8 and time from onset to admission≤3 h;(4)good liver and kidney function;and(5)complete case data.The included patients were divided into DC group and PD+DC group.The patients were followed up for 6 months.The outcome was assessed by Glasgow outcome scale(GOS)score,Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis.A good outcome was defined as independent(GOS score,4-5)and poor outcome defined as dependent(GOS score,3-1).All data analyses were performed using SPSS 19,and comparison between two groups was conducted using separatet-tests or Chi-square tests.Results:A total of 65 patients was included.The age ranged 34-90 years(mean,63.00±14.04 years).Among them,31 patients had the operation of PD+DC,whereas 34 patients underwent DC.The two groups had no significant difference in the basic characteristics.After 6 months of follow-up,in the PD+DC group there were 8 death,4 vegetative state,4 severe disability(GOS score 1-3,poor outcome 51.6%);8 moderate disability,and 7 good recovery(GOS score 4-5,good outcome 48.4%);while in the DC group the result was 15 death,6 vegetative state,5 severe disability(poor outcome 76.5%),4 moderate disability and 4 good recovery(good outcome 23.5%).The GOS score and good outcome were significantly less in DC group than in PD+DC group(Z=-1.993,p=0.046;χ2=4.38,p=0.043).However,there was no significant difference regarding the survival curve between PD+DC group and DC group.The correlation between the time from admission to operation and GOS at 6 months(r=-0.41,R2=0.002,p=0.829)was not significant in the PD+DC group,but significant in the DC group(r=-0.357,R2=0.128,p=0.038).Conclusion:PD+DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude. 展开更多
关键词 Intracranial hemorrhage HYPERTENSIVE High altitude cerebral hernia Hematoma puncture drainage Decompressive craniectomy
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Massive subdural hematoma misdiagnosed as delayed encephalopathy of carbon monoxide poisoning: a case report and literature review 被引量:1
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作者 Xiaolong Sun Yi Bao +1 位作者 Lan Zhou Guangjian Liu 《Journal of Translational Neuroscience》 2021年第1期33-38,共6页
Subdural hematoma is often secondary to brain trauma and other diseases.The onset is hidden and the condition is critical.Timely detection and early treatment are particularly important.The patient denied a history of... Subdural hematoma is often secondary to brain trauma and other diseases.The onset is hidden and the condition is critical.Timely detection and early treatment are particularly important.The patient denied a history of trauma,but had a history of consciousness loss after charcoal burning.The clinical symptoms were progressive cognitive impairment.The initial diagnosis was delayed encephalopathy caused by carbon monoxide poisoning.However,computed tomography(CT)scan of the brain showed a large area of subdural hematoma on the left side and the formation of a cerebral hernia,which was life-threatening.The patienfs symptoms gradually improved after an emergency operation. 展开更多
关键词 subdural hematoma delayed encephalopathy of carbon monoxide poisoning(DEACMP) cerebral hernia cognitive impairment DEMENTIA
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