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CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2023; 84(03): 281-287
DOI: 10.1055/s-0042-1745737
Original Article

Surgical Treatment for Severe Primary Midbrain and Upper Pons Hemorrhages Using a Subtemporal Tentorial Approach

Jie Wu
1   Department of Neurosurgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, Hubei, China
,
Xiao Wu
2   Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
,
Yong Zhang
3   Department of Neurosurgery, Beidaihe Rehabilitation and Recuperation Center of Chinese People's Liberation Army, Qinhuangdao, China
,
Wei Du
1   Department of Neurosurgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, Hubei, China
,
Ke Wei
1   Department of Neurosurgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, Hubei, China
,
Guo Jie Yao
1   Department of Neurosurgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, Hubei, China
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Abstract

Objectives It is unclear whether surgical hematoma evacuation should be performed in cases of primary brainstem hemorrhages (PBH). Here, we analyzed 15 cases with severe primary midbrain and upper pons hemorrhages to assess the associations between the subtemporal tentorial approach and patient functional outcomes and mortality.

Design A total of 15 patients diagnosed with severe primary midbrain and upper pons hemorrhages who had previously received the subtemporal tentorial approach at our facility from January 2018 and March 2019 were analyzed. All surviving cases received a follow-up at 6 months after surgery. The Glasgow Coma Scale and Glasgow Outcome Scale (GOS) scores were analyzed 1 and 6 months after surgery, respectively. Demographic data, lesion characteristics, and follow-up data were retrospectively collected.

Results All patients successfully underwent surgical evacuation for hematomas using the subtemporal tentorial approach. The overall survival rate for these cases was 66.7% (10/15). At the last follow-up, 26.7% of patients (4/15) exhibited healthy function (GOS score: 4), 20.0% (3/15) showed disability (GOS score: 3) and 20.0% (3/15) were in a vegetative state (GOS score: 2).

Conclusions Based on the results uncovered in this study, the subtemporal tentorial approach was found to be both safe and feasible and may be beneficial for the treatment of severe primary midbrain and upper pons hemorrhages, but a more comprehensive and comparative study is required to further confirm these results.

Keywords

primary brainstem hemorrhage - subtemporal tentorial approach - outcomes


Publication History

Received: 12 September 2020

Accepted: 17 February 2022

Article published online:
19 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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