A prospective study on the treatment of hypertensive intracerebral hemorrhage with hematoma evacuation via different approaches
WANG Qimin
GAO Fei
QIAO Qingjun
Abstract：Objective To explore the application value of small bone window hematoma evacuation via the inferior Rolandic point-insular approach through the lateral fissure(i.e.,surgery via the lateral fissure approach)and traditional small bone window hematoma evacuation via the temporal lobe cortex approach(i.e.,surgery via the temporal lobe approach)in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods Ninety patients with HICH were prospectively selected and randomly divided into a traditional group and a modified group,with 45 patients in each group,using a simple randomization method.The traditional group underwent surgery via the temporal lobe approach,while the modified group underwent surgery via the lateral fissure approach.The surgical conditions,postoperative recovery,cerebral oxygen metabolism indicators before and after surgery[jugular vein oxygen content(CjvO2),arterial jugular vein oxygen content difference(Da-jvO2),and arterial oxygen content(CaO2)],National Institutes of Health Stroke Scale(NIHSS)scores,Glasgow Outcome Scale(GOS)scores,and complications were compared between the two groups.Results The hematoma evacuation rate 24 hours after surgery was higher in the modified group than in the traditional group,and the depth of white matter incision and the length of hospital stay were lower in the modified group(all P<0.05).Seven days after surgery,CjvO2 was higher in the modified group than in the traditional group,while CaO2 and Da-jvO2 were lower(all P<0.05).Six months after surgery,the NIHSS score was lower and the GOS score was higher in the modified group than in the traditional group(all P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions Surgery via the lateral fissure approach for HICH can improve the hematoma evacuation effect,enhance cerebral oxygen metabolism,promote postoperative recovery,facilitate the restoration of neurological function,and improve prognosis.Its safety is comparable to that of surgery via the temporal lobe approach.
Keywords：intracranial hemorrhagehypertensivehematoma evacuationapproachvia the lateral fissurevia thetemporallobecerebral oxygen metabolismprognosis
Publication Date：2025-10-20
Online Publishing Date：2025-12-01(First online date of this platform, not the publication date of the document)
Pages：4( 580-583 )