Three-dimensional reconstructed CT scanning for targeting hypertensive putaminal hemorrhage.
We developed an accurate frontal targeting method for hypertensive putaminal hemorrhage (HPH) using three-dimensional (3D) reconstructed CT scanning. Five consecutive unconscious patients with a significant volume of HPH were treated neuroendoscopically via frontal trephination. CT images were examined and reconstructed by an independent neuroradiologist for measuring the selected frontal entry point, depth of penetrating path, and surgical trajectory on the basis of the plane formed by the bilateral orbitomental lines delineated on the reconstructed 3D CT images. All patients regained consciousness post-operatively without complications. All had an accurate trajectory of penetrating path and the average percentage hematoma evacuation was 84%. Use of the 3D reconstructed CT imaging technique combined with neuroendoscopy may prove valuable as a minimally invasive and time-saving method of targeting HPH. Using this method, no further CT scanning is needed for subsequent surgical planning.
Lin
Hung-Lin
HL
Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.
Lo
Yu-Chien
YC
Chen
Chun-Chung
CC
Chiou
Shang-Ming
SM
Lee
Han-Chung
HC
Huang
Hsiang-Ming
HM
Cho
Der-Yang
DY
D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020146:Putaminal Hemorrhage / Q000150:complications / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*