[The surgical strategy of microsurgical treatment for fulminant hemorrhagic dilation of the fourth ventricle].

Objective

To investigate the effectiveness and advantage of improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle.

Methods

The clinical data of 21 patients with fulminant hemorrhagic dilation of the fourth ventricle were analyzed retrospectively.All patients underwent hemorrhage evacuation and improved atlantooccipital decompression via middle suboccipital trans-cerebellar vermis approach, with preceding external ventricular drain.

Results

One patient died of brainstem failure postoperative, and 20 patients were followed up from 6 to 17 months.There were 8 patients whose KPS exceeded 90, 6 patients whose KPS were 60 to 90, 4 patients whose KPS were 30 to 60, and two patients whose KPS were lower than 30.There was no recurrence of hydrocephalus and posterior fossa fluid.

Conclusions

The improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle not only could effectively raise the success rate of salvage, but also greatly reduce postoperative complications compared with traditional mode.