Effect of micro-assisted small bone flap craniotomy combined with Viewsite brain retractor on treatment of hypertensive intracerebral hemorrhage

Abstract

Objective To investigate the clinical effect of micro-assisted small bone flap craniotomy combined with Viewsite brain retractor on treatment of hypertensive intracerebral hemorrhage (HICH). Methods One hundred and eighteen patients diagnosed as HICH admitted to the Department of Neurosurgery, The 901st Hospital of the Joint Logistics Support Force of PLA from June 2016 to June 2018. Among them, 53 patients had microsurgery with small bone flap craniotomy combined with Viewsite brain retractor (minimally invasive group), other 65 patients underwent routine craniotomy combined with cortical fistula (control group). The changes of perioperative parameters and postoperative complications were compared between the two groups. GOS score and modified Rankin scale (mRs) neurological function score were followed up 6 months later. Results Compared with the control group, the minimally invasive group had shorter operation time, less intraoperative hemorrhage, higher clearance rate of hematoma, shorter hospitalization time in NICU and higher GCS score at 14 d after operation, while the tracheotomy rate, edema area and pulmonary infection at 7 d after operation were significantly reduced (P 0.05). The GOS score and mRs score of the minimally invasive group were significantly better than those of the control group 6 months after operation (P<0.05). Conclusion Microscopically assisted small bone window combined with Viewsite brain retractor for HICH has the characteristics of less bleeding and trauma, complete removal of hematoma, and fewer complications. Postoperative neurological function recovery is good, and the clinical effect is remarkable. Key words: Small bone window; Brain retractor; Microscope; Hypertensive intracerebral hemorrhage