Surg Neurol
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Comparative Study Clinical Trial Controlled Clinical Trial
The effects on prognosis of surgical treatment of hypertensive putaminal hematomas through transsylvian transinsular approach.
Hypertensive putaminal hematoma (HPH) is a devastating type of stroke that mostly results in death or severe neurologic deficit. There seems to be no general agreement on the selection of treatment modality for individual patients. In this study a comparison has been made between conservative treatment and the results of surgical treatment through the transsylvian transinsular approach of HPH with 30 cc or more. ⋯ Surgical treatment via transsylvian transinsular approach of HPH with a volume of 30 cc or more results in improved outcome as compared to conservative treatment. Operation time within the first 36 hours after ictus did not affect the outcome.
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If nerve tissue is capable of inducing regeneration, as suggested by the neurotropism theory, then even small pieces of nerve tissue should have the potential to induce nerve regeneration. Therefore, long gaps might presumably be bridged via the neurotrophic potential of small pieces of nerve tissue grafted into the middle of the nerve gap. It is necessary to confirm the validity of the neurotropism theory and to also explore the potential usefulness of small nerve grafting through long gaps. ⋯ Small nerve grafts are capable of inducing nerve regeneration even over a long nerve gap, by grafting nerve tissue into the middle of the lesion using a silicone tube.