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Surgical treatment for middle cerebral artery aneurysmwith intracerebral hematomaaround lateral fissure

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Author:
No author available
Journal Title:
Chinese Journal of Neurosurgery
Issue:
7
DOI:
10.3760/cma.j.issn.1001-2346.2012.07.007
Key Word:
大脑中动脉瘤;外侧裂血肿;手术;Middle cerebral artery aneurysm;Intracerebral hematoma;Surgery

Abstract: Objective To study surgical treatment for middle cerebral aneurysm (MCA) with intracerebral hematoma around the lateral fissure.Methods 31 cases of MCA with intracerebral hematoma (volume of hematoma was more than 20ml) around the lateral fissure were treated surgically in our hospital from January 2005 to February 2012.Their clinical data were colleted and the surgical shortages were studied from the aspects of anatomy and surgical techniques.Results The surgical shortages included:The bone window was too small due to poor preoperational incision design; The incision of anterior temporal cortex was too short when eliminating hematoma; Insufficient attention was paid to the elimination of intracerebral hematoma occurred after successful aneurysm occlusion ; The bleeding wasn1 stopped carefully ; Some "early organized" hematomas with hard texture near the aneurysm and important branches were excessively eliminated,thus leading to branch injury.Conclusions The incisions of scalp and temporal cortex should be properly enlarged or extended to the direction of posterior temporal lobe,which is beneficial to the clearance of temporal hematoma.Some "organized" hematomas adhering to the aneurysm and near the important branches of parent artery should be cleared appropriately.

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