Research Article

Prognosis and Influencing Factors of Early Microsurgery for Severe Hypertensive Brainstem Hemorrhage

Figure 1

Forty-eight years old, male, who was admitted to the hospital with sudden unconsciousness for 3 hours. Physical examination: The patient was in coma with respiratory failure and tracheal intubation. Bilateral pupils were 1.5 mm, and the light reflex was negative. The patient was quadriplegic and bilateral Babinski’s sign positive. Preoperative brain CT showed that the brainstem hematoma was located in the upper part of the pons, which was of unilateral tegmental type (a). The hematoma was cleared by subtemporal approach. Brain CT at 24 hours after operation showed that pons hemorrhage was cleared satisfactorily (b). Fifty-four years old, male, admitted to the hospital with sudden unconsciousness for 1 hour. Physical examination: The patient was in coma with bilateral miosis and negative for light reflex. The patient presented with quadriplegia, hypotonia, and bilateral Babinski’s sign positive. Preoperative brain CT showed that the hematoma was located in the middle and lower part of the pons, which was of bilateral tegmental type (c). The hematoma was cleared through the retrosigmoid sinus approach. Brain CT at 24 hours after operation showed that pons hematoma was completely cleared and the fourth ventricle was clear (d).
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