医学
第三脑室
脑室出血
血肿
心室
外科
病变
脑室
格拉斯哥昏迷指数
第四脑室
麻醉
心脏病学
内科学
胎龄
怀孕
生物
遗传学
作者
Huaiyu Sun,Yue Wang,Shu Yu,Zifan Li,Tingzhong Wang
标识
DOI:10.1016/j.wneu.2020.07.177
摘要
Although surgeries for intracerebral hemorrhage remain controversial, endoscopic surgery is considered a promising surgical treatment. The most fatal type of thalamic hemorrhage is the medial type, which is always combined with expansion of the hematoma into the third ventricle. The current endoscopic approach to this lesion involves injury to the mediodorsal nucleus of the thalamus (MDT). We report 5 cases of medial thalamic hemorrhage with third intraventricular involvement treated by an endoscopic-assisted translateral ventricular transchoroidal fissure approach. The preoperative average volume of the parenchymal hematomas was 9.63 mL, while the preoperative average volume of the intraventricular hematomas was 23.35 mL. The average surgical duration was 80.6 minutes. No intraoperative MDT incision was needed in any patient. The evacuation rates of parenchymal and intraventricular hematomas were 74.21%−98.84% and 85.89%–99.51%, respectively. Three months after the surgery, the average Glasgow Coma Scale scores improved to 13.8 from 7.2 preoperatively. No ventriculoperitoneal shunt was needed in any patient. The endoscopic-assisted translateral ventricular transchoroidal fissure approach is a safe and effective approach for evacuation of a medial thalamic hemorrhage with third intraventricular involvement. This approach allows parenchymal hematoma evacuation through the rupture of the third ventricle without incising the MDT in the lateral ventricle.
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