Surgery at Early Stage for Hypertensive Cerebral Hemorrhage Of III Degree

Objective To observe the curative effect of both the decompressive large craniotomy combined with evacuation of the hematoma and craniotomy with small bone window for evacuation of the hematomas at early stage on thypertensive cerebral hemorrhage of Ⅲ degree.Methods Of 121 patients with hypertensive cerebral hemorrhage of Ⅲ degree,78 were treated by craniotomy with small bone window for evacuation of the hematomas and 43 by decompressive large craniotomy combined with evacuation of the hematomas at early stage after the hemorrhage.Following-up was performed 1 month and 6 months respectively after the operation.The curative effect,extent of evacuation of the hematomas and operative complications were compared between both the groups.Results There was insignificant difference in the extent of evacuation of the hematomas,operative complications(except stress ulcer),mortality and prognosis between both the groups 1 month and 6 months after the operation.Compared with decompressive craniotomy group,the small bone window craniotomy group had significantly lower rate of the postoperative stress ulcer,shorter operative duration and less bleeding during the operation.Conclusion The craniotomy with small bone window for the evacuation of the hematoma should be first selected for the treatment of hypertensive cerebral hemorrhage of Ⅲ degree at early stage after the hemorrhage.