Abstract:

[Abstract] Objective To investigate the therapeutic effect of the lateral fissure opened intraoperative cerebral con? tusion sylvian cistern , basal cistern for improving the cerebral vasospasm. Methods A total of106patients withcerebral contusion in lateral fissure area were randomly divided into2groups. The control group was given conventional craniotomy to clear focal cerebral contusion of hematoma. And the experimental group was further to fully open sylvian cistern, jugular vein pool, endplate pool and basal cistern on the basis of the conventional craniotomy to remove the brain contusion and hemato? ma. The levels of endothelin1(ET-1) in plasma and cerebrospinal fluid (CSF) were detected postoperative 3, 7and14days. The Glasgow coma scale (GCS) score, ICU guardianship time and total length of hospital stay were observed on discharge and followed up for 3months in two groups. The rate of good prognosis was compared between two groups.Results There were significant differences in ET-1levels of plasma and CSF at different time points (plasma Ftime =603.436and CSFFtime = 684.276) between two groups of patients (plasma Ftime =272.531and CSFF=317.641). The ET-1levels were significantly lower after 7d and14d treatment in experimental group, but no significant difference3d after operation between two groups (P<0.01). The GCS score was significantly higher on discharge in experimental group than that of control group. The values of ICU guardianship time and the total hospitalization time were both significantly lower in experimental group than those of control group (P<0.01). The rate of good prognosis was significantly higher in experimental group than that of control one [78.85% (41/52) vs 51.85% (28/54), χ 2 =8.496, P<0.01]. Conclusion Openning side crack pool and basal cistern in the surgical treatment of traumatic brain injury can improve the cerebral vasospasm and prognosis.

Key words: open side crack pool, lateral fissure area hedge, traumatic cerebral vasospasm, endothelin 1