| A Supine Suboccipital Lateral Approach for Stereotactic Aspiration of Cerebellar Hematoma |
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Sung Eun Jung, Myung Ki Lee, Seong Hyuk Hwang, June Woo Park, Jae Eon Lee, Chang Weon Cho, Dae Jo Kim |
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Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea |
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| Abstract |
Objective
We report a suboccipital lateral approach in order to propose more suitable stereotactic technique for cerebellar hematoma.
Methods
Using the Leksell's CT-stereotactic system, the patient was kept on a supine position under local anesthesia turning the head 30 to 40 degrees contralateral to the side of the lesion and bending the neck forward, so that the approach was made laterally toward the ipsilateral suboccipital area. 15 patients with cerebellar hematoma underwent this stereotactic technique. 11 patients complicated with intraventricular hemorrhage or obstructive hydrocephalus underwent simultaneously external ventricular drainage (EVD) via Kocher's point without a change in patient's position. The residual hematoma was drained out by urokinase irrigation through stereotactically placed catheters.
Results
All procedures could be done in a comfortable supine position without diffiuclty under local anesthesia in all cases. The mean time of operation was about one hour and forty minutes in cases combined with EVD and one hour and twenty minutes in cases not. The drainage catheter in the hematoma was removed on average at postoperative 3.5 day and EVD at postoperative 6.7 day.
Conclusion
We consider that this surgical technique has many useful benefits that can be rapidly done under local anesthesia in a comfortable supine position and that can be relatively safe, and minimally invasive. It also has benefits that EVD can be done without any change in position. |
| Key Words:
Cerebellar hematoma, Suboccipital lateral approach, Stereotactic technique. |
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