Wang Yuhai, Wang Chunli, Cai Sang, Dong Jirong, Yang Likun, Chen Lei, Maas Andrew
101 Hospital of Chinese People's Liberation Army, Department of Neurosurgery,Wu Xi, Jiang Su, China.
Turk Neurosurg. 2014;24(2):228-33. doi: 10.5137/1019-5149.JTN.8377-13.0.
To review our experience in the surgical treatment of TISH, and to analyze prognostic factors.
Clinical and imaging data, surgical modalities, and outcomes of 21 patients with TISH who were treated with microsurgery were analyzed retrospectively. Prognostic factors for outcome were analyzed by univariate analysis.
Long-term follow up with outcome assessment according to the Glasgow Outcome Scale (GOS) showed good recovery in 16 cases, moderate disability in two cases, severe disability in one case, and death in two cases. During surgery the origin of bleeding could be identified in all 21 cases. A rupture of the distal anterior cerebral artery or veins in the interhemispheric fissure was seen more frequently in patients with whole interhemispheric fissure hematoma, while hemorrhage from brain tissue laceration was seen more frequently in patients with more localized hematomas. The outcome in patients with an identified rupture of a vessel was better than in those with cortical laceration. Preoperative GCS score and thickness of the interhemispheric hematoma were correlated with outcome (P=0.001 and P=0.004, respectively).
Outcome after surgical treatment for TISH can be good, and careful surgical planning and microsurgical techniques to preserve venous drainage are essential.
回顾我们在创伤性脑室内出血（TISH）手术治疗方面的经验，并分析预后因素。
回顾性分析21例接受显微手术治疗的TISH患者的临床和影像学资料、手术方式及结果。通过单因素分析对预后因素进行分析。
根据格拉斯哥预后量表（GOS）进行结局评估的长期随访显示，16例恢复良好，2例中度残疾，1例重度残疾，2例死亡。手术过程中，21例均能明确出血来源。全大脑纵裂血肿患者中，大脑前动脉远端或大脑纵裂内静脉破裂更为常见，而局限性血肿患者中，脑组织裂伤出血更为常见。血管破裂明确的患者预后优于皮质裂伤患者。术前格拉斯哥昏迷量表（GCS）评分和大脑纵裂血肿厚度与预后相关（分别为P = 0.001和P = 0.004）。
TISH手术治疗后的预后可能良好，精心的手术规划和保留静脉引流的显微手术技术至关重要。
