Comparative analysis of small bone window craniotomy and conventional bone flap craniotomy with hypertension cerebral hemorrhage

Abstract

Objective To explore and compare the clinical efficacy of small bone window craniotomy with conventional bone flap craniotomy in the treatment of patients with hypertensive cerebral hemorrhage. Methods Seventy two cases of hypertensive cerebral hemorrhage patients treated in the Department of Neurosurgery, Gaomi People’s Hospital from May 2016 to March 2018 were involved in this study. According to random number table method, all of patients were divided into two groups. Forty cases who were performed small bone window craniotomy treatment through lateral fissure approach as bone window group, 32 cases who were performed traditional bone flap craniotomy treatment as bone flap group. Operation time, intraoperative blood transfusion volume, intracranial pressure at 6, 24, 72 h and 1 week after operation were compared between the two groups, and the ADL score was evaluated after 3 months follow-up. Results Operation time, intraoperative blood transfusion volume in bone window group were significantly better than the bone flap group.there were no statistical significances on intracranial pressure at 6, 24 h after operation between the two groups, but there was difference at 72 h, 1 week after operation, the intracranial pressure in bone window group was higher than that in the bone flap group. After dehydration or release of part of cerebrospinal fluid, intracranial pressure can be controlled within normal range 33 cases(85.0%) recovered well in observation group, which was better than control group (22 cases, 68.7%), there was statistical difference (P<0.05). Conclusion Compared with conventional bone flap craniotomy surgery in the treatment of hypertensive cerebral hemorrhage patients, small bone window craniotomy has the characters of evident clinical effect, safe and reliable, and has important clinical value. Key words: Intracranial hemorrhage; Lateral fissure; Small bone window craniotomy