Microsurgery with small bone flap craniotomy and lateral fissure approach in treatment of hypertensive hemorrhage of basal nuclei region

Objective: To explore the effectiveness and operative technique of microsurgery through lateral fissure approach for treating hypertensive hemorrhage of basal nuclei region(HBNH).Methods: Twenth-two patients with HBNH accepted at the early stage the microsurgery through small skull window behind pterion and lateral fissure approach to remove the hematoma after they were diagnosed by CT that the hematoma volume is 30-70 ml and no cerebral hernia occurred.Results: The CT reexamination within postoperative 12 hours showed that the hematoma was removed by over 80% were 77.2%,below 70%in 1 case;Postoperative rebleeding(<10 ml) occurred in 1 case;After 6 months follow-up,the ADL was good were 72.7% and the mortality was 13.6%.Conclusions: With proper case selection,microsurgery through lateral fissure approach is a kind of minimal invasive method with little damage,good exposure,comparatively complete hematoma removal,desirable effect of decompressing the intracerebral pressure and stopping the blood flow,favorable recovery of neural functions and low morbidity and mortality.