Ultra-early keyhole surgery for expansile hypertensive basal ganglia hematoma
LI Wenhui
REN Honggang
SONG Yang
GUO Jian
CHEN Yixiong
Abstract：Objective To investigate the feasibility and efficacy of ultraearly keyhole surgery for expansile hyperten-sive basal ganglia hematoma.Methods The clinical data of 69 patients with expansile hypertensive basal ganglia hematoma treated by keyhole surgery in the Department of Neurosurgery,Linfen People's Hospital between July 2022 and June 2024 were retrospectively analyzed.All patients underwent microscopic surgery via a pterional keyhole transsylviantransinsular approach within 6 h after onset.Results The operative time ranged from 65 to 150 min(mean,106±18 min).Postoperative cranial CT on the first day showed hematoma evacuation>90%in 51 cases,80%～90%in 13 cases,and 70%～80%in 5 cases,with an aver-age evacuation rate of(91.3 ± 5.5)%.The GCS score at 3 days postoperatively[(13.7 ± 0.9)points]was significantly higher than that before surgery[(10.0 ± 2.4)points;P <0.01].Postoperative complications included intracranial rebleeding in 1 case,pul-monary infection in 9 cases,intracranial infection in 2 cases,and gastrointestinal bleeding in 1 case.At 6 months after surgery,the GOS score was 5 in 37 cases,4 in 25 cases,and 3 in 7 cases;the rate of favorable prognosis(GOS score 4～5)was 89.9%.Conclusion For expansile hypertensive basal ganglia hematoma,ultraearly microscopic surgery via a pterional keyhole trans-sylviantransinsular approach is safe,straightforward,efficient,and minimally invasive,achieving a high hematoma evacuation rate and significantly improving patient prognosis.
Keywords：expansile hypertensive basal ganglia hematomaultraearlykeyhole surgerytranssylviantransinsular ap-proachefficacy
Publication Date：2026-01-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：4( 32-35 )