Puncture and drainage in the treatment of acute traumatic intracranial hematoma

Abstract

Objective To explore the puncture treatment of the acute traumatic intracerebral hematoma, clear the feasibility, curative effect and treatment indications, improve the prognosis and success rate of treatment. Methods There were 27 typical acute traumatic intracerebral hematoma cases from January 2000 to May 2003, the volume between 15-60 ml, CT positioning the center of hematoma and puncture point, minimally invasive puncture hematoma, then suction, urokinase liquefaction, drainage and clearance the hematoma, within 3 days pulling out the puncture needle after CT displaying of the hematoma clearanced almostly. Result Compare the postoperative CT measurement with preoperative, the hematoma amount reduce 30%-60%, all of the hematoma was basic clearanced within 3 days. All cases were recovered, 10 cases with preoperative coma awaked after 1-5 days, 12 cases of headache symptom apparently alleviated on the day of surgery, contralateral limb weakness in 15 cases, 3 cases improved, after the operation 10 cases gradually improved a month later, 2 cases with limb light paralysis; 3 cases had mild language barriers 6 months later, contralateral limbstrength grade 3 in 2 cases, 5 cases of serious intellectual decline; secondary hydrocephalus in 1 cases, 3 cases of epilepsy, without intracranial effusion or chronic hematoma. According to the ADL classification, 18, 5, 4 weae in grade Ⅰ,gradeⅡ, gradeⅢ. Conclusion The puncture removal treatment of acute traumatical intracerebral hematoma is minimally invasive, less complications, the prognosis is good. Key words: Traumatic acute intracranial hematoma; Puncture drainage