Clinical study of evacuation of hematoma in supratentorial hypertensive cerebral hemorrhage under neuroendoscopy

Abstract

Objective To explore the value of neuroendoscopic approach for hematoma evacuation in the treatment of supratentorial hypertensive cerebral hemorrhage. Methods From January 2017 to December 2018, a total of 56 patients with supratentorial hypertensive cerebral hemorrhage were studied. Using of 3D-Slicer software and mobile phone software to locate the hematoma site. Hematoma evacuation was performed under neuroendoscopic approach. After operation, hematoma clearance rate and rebleeding, secondary cerebral edema and the related complications such as aspiration pneumonia were observed by CT. Glasgow Outcome Scale (GOS) was used to evaluate prognosis, Barthel Index (BI) was used to evaluate activities of daily living, and the incidence of complications such as pulmonary infection and rebleeding was recorded. Results All of the 56 patients successfully completed the neuroendoscopic approach operation. Hematoma clearance rate was > 85% . There was no secondary hydrocephalus occurred. Six patients (10.71%) developed pulmonary infection, one patient (1.79%) occurred rebleeding. After an average follow-up of 8 months, 11 cases (19.64%) recovered well; 27 cases (48.21%) lightly disabled; 15 cases (26.79%) severely disabled; and 3 cases (5.36% ) were living in vegetative state; and there were no death. In BI scores, 30 cases > 60, 8 cases were 40-60, 15 cases were 20-40, 3 cases were 0. Conclusions The neuroendoscopic surgery approach for treatment of supratentorial cerebral hemorrhage is simple, easy to operate with less damage and lower incidence of complications. The required equipments are simple and more suitable for basic-level hospital.

DOI:10.3969/j.issn.1672-6731.2019.09.010