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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Transtentorial herniation in patients with hypertensive putaminal haemorrhage is predictive of elevated intracranial pressure following haematoma removal
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Transtentorial herniation in patients with hypertensive putaminal haemorrhage is predictive of elevated intracranial pressure following haematoma removal

机译：高血压腹泻性出血的经颅疝可预示血肿清除后颅内压升高

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摘要

We investigated surgical outcomes of haematoma evacuation in patients with hypertensive putaminal haemorrhage, with emphasis on the development of postoperative refractory intracranial hypertension. Twenty-two consecutive patients with hypertensive putaminal haemorrhage underwent microsurgical clot removal without decompressive craniectomy. Medical histories, radiographic findings, and surgical notes were reviewed. Twenty patients survived to discharge. Twelve patients with preoperative transtentorial herniation, demonstrating a greater haematoma volume and lower Glasgow Coma Scale (GCS) score, had significantly elevated postoperative intracranial pressure. Five of these patients developed refractory intracranial hypertension (42%), and two of these patients died. Conversely, none of the 10 patients without preoperative transtentorial herniation experienced refractory intracranial hypertension, and they had a better outcome at discharge. The preoperative presence of clinical transtentorial herniation may predict the development of postoperative refractory intracranial hypertension, which may require decompressive craniectomy.
机译：我们调查了高血压性腹泻性出血患者血肿疏散的手术结局，重点是术后难治性颅内高压的发展。连续22例高血压性腹泻性出血患者在不进行减压颅骨切除术的情况下接受了显微外科血凝块清除术。回顾病史，影像学发现和手术记录。二十名患者幸免于难。十二名术前经颅椎间盘突出症患者表现出更大的血肿量和更低的格拉斯哥昏迷量表（GCS）评分，术后颅内压明显升高。这些患者中有5例发展为难治性颅内高压（42％），其中2例死亡。相反，没有术前经颅疝的10例患者中没有一个经历过难治性颅内高压，并且出院时的转归较好。术前临床上经颅疝的存在可能预示了术后难治性颅内高压的发展，这可能需要减压颅骨切除术。

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