A Recearch On Minimally Invasive Intracranial Hematoma Dual-X Positioning Method

Cerebral Hemorrhage is a stroke subtype and one of the severe acute diseasesin Neurology. It is one of the Cerebrovascular Disease with high rate of mortality anddisability. The main reasons of Cerebral Hemorrhage are Hypertension, CerebralAmyloid Angiopathy, Aneurysms,Vascular Malformations, and anticoagulant drugsmay also cause this disease in a few cases. The Treatment of Cerebral Hemorrhageemphasizes on comprehensive of Medicine and Surgery treatment. Medicaltreatment is the basis which covers: to regulate blood pressure, to keep the airwayopen, to reduce intracranial pressure and to prevent the stress ulcer. It also includescatheterization, nasogastric feeding, nutritional support, the prevention of electrolyteimbalance, skin care and some other aspects of treatment. Some patients needsurgical intervention due to special bleeding site and the large amount of bleeding.The main purpose of surgical treatment is to remove the hematoma, to reduce themass effect, to reduce the neurotoxicity of the hematoma on the surrounding braintissue, to reduce the edema of the surrounding brain tissue, and to improveneurological function. The technique of surgical started from DecompressionCraniectomy in the very beginning, then some other treatment shows up as followsafter CT’s appearance: the Stereotactic Hematoma Removal, the NerveEndoscopic-assisted Minimally Invasive Hematoma Evacuation, the MinimallyInvasive Removal of CT oriented Hematoma, Nerve Navigation Minimally Invasivedissection. Minimally Invasive Surgery is the future direction of surgical treatment forcerebral hemorrhage. CT guided Hematoma Minimally Invasive Removal is widelycarried out in our country, with low equipment requirements, simple, rapid, efficient,and particularly suitable for elder people who cannot use general anesthesia, andalso suitable for people who are with a variety of diseases combined. Years ofpractice shows that to puncture at a reasonable hematoma Center, you can maximizesuction hematoma, improve efficacy, precise puncture is assured though precise positioning. Nowadays, the normal way of positioning is to use the metal markerpositioning method under the CT. The details of this specific methods is to place alinear metal positioning along the long axis of Skull head surface (bleeding side) andvertically, accompanied by CT scan, select the maximum level of the hematoma,locate marked surface of the skull to determine the actual hematoma puncture point.This method is simple and widely adopted; the disadvantage is cumbersome, patientsneed to be accompanied by a CT scan positioning and will be occupied surgeon time.The positioning may with some tolerance in the process of mobile CT bed, open lasermarking, scribing due to reasons such as high intracranial pressure agitation. Thatwill result in positioning not that precise, especially for positioning failedhypothalamus small amount of bleeding. Other positioning methods, such asexperience in positioning, secondary positioning method, the strings from thepositioning method, H positioning method, the six-lane grid positioning method,MARK positioning method, brain CT positioning paste are seldom used. Experiencepositioning method is simple, imprecise and only suitable for a large number ofpatients with basal ganglia hemorrhage. Secondary positioning method is relativelyaccurate but tedious string from the positioning method. H positioning method, thesix-lane grid positioning method, brain CT positioning stickers, MARK positioningmethod improve accuracy, but some methods cumbersome positioning standardproduction, and some need to scan along the OM line, some need estimates, anddifficult to use it widely. To develop a set of simple, accurate and efficient positioningmethod is especially necessary. So we carried out Minimally Invasive IntracranialHematoma dual-X method positioning in2010, and shoot the problems we metbefore. This positioning standard production is simple, the positioning principle iseasy to understand, scanning level is not fixed. After20cases in different parts of thecerebral hemorrhage patients minimally invasive positioning, the results show thatthe effect is better than the metal marker positioning under CT method. Minimally Invasive Intracranial Hematoma dual-X method positioning is a simple, accurate,saving, time-saving positioning method.Objective: To evaluate the surgical significance and curative effect of IntracranialHematoma Minimally Invasive Intracranial Hematoma dual-X method positioning forCerebral Hemorrhage in the minimally invasive treatment of cerebral hemorrhage.Method: The40patients who are with this R&D requirements were randomly dividedinto2groups,20for each. The first group of patients will use Minimally InvasiveIntracranial Hematoma dual-X method positioning, the second group will use themetal marker positioning under CT. To compare the distances from the practicalpuncture needle tips to the target point24hours after the urgent, also to compare thepositioning timing and cost of two different positioning methods.Results: Minimally Invasive Intracranial Hematoma dual-X positioning method(Group1):16puncture needle tip out of20cases were within3mm from the targetpoint; Metal marker positioning under CT method group (Group2):5out of20caseswere within3mm from the target point. The precision of Group1is better than Group2,besides, the Minimally Invasive Intracranial Hematoma dual-X positioning methodsaves the positioning crossed time,without CT-guided, save cost.Conclusion: the intracranial hematoma minimally invasive Dual-X positioning methodis intuitive and accurate, simple, economic and time-saving. It’s the precisepositioning treatment for the minimally invasive intracranial hematoma.