Surgical Treatment for Primary Brainstem Hemorrhage to Improve Postoperative Functional Outcomes

Shinya Ichimura, Helmut Bertalanffy, Masato Nakaya, Yoichi Mochizuki, Goroku Moriwaki, Ryuichi Sakamoto, Masahito Fukuchi, Koji Fujii

研究成果: Article査読

29 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)e1289-e1294
ジャーナルWorld neurosurgery
120
DOI
出版ステータスPublished - 2018 12月
外部発表はい

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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