Optimal time window for minimally invasive surgery in treating spontaneous intracerebral hemorrhage in the basal ganglia region: a multicenter and retrospective study.

Autor: Xiao K; Department of Neurology, People's Hospital of Ganxian District, Ganzhou, China., Chu H; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China., Chen H; Department of Neurology, People's Hospital of Ganxian District, Ganzhou, China., Zhong Y; Department of Neurology, National Hospital, Guangxi Medical University, Nanning, China., Zhong L; Department of Neurology, National Hospital, Guangxi Medical University, Nanning, China., Tang Y; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Jazyk: angličtina
Zdroj: British journal of neurosurgery [Br J Neurosurg] 2023 Oct; Vol. 37 (5), pp. 1061-1065. Date of Electronic Publication: 2020 Dec 08.
DOI: 10.1080/02688697.2020.1854682
Abstrakt: Background: The current treatment spontaneous intracerebral hemorrhage (sICH) is limited.
Aim: To determine the optimal time window for minimally invasive surgery in patients with sICH.
Materials and Methods: sICH patients with a hematoma volume of 30-80 mL in the basal ganglia region were included in our study. A total of 357 patients were divided into groups according to different operative times from ICH onset (group 1: 0-6 h, group 2: 6-12 h, group 3: >12 h) and hematoma volumes (30-50 mL and >50 mL). All patients were followed-up for three months' post-operation, and their clinical outcomes were compared.
Results: In the three groups of patients with hematoma volumes of 30-50 mL, the rebleeding and mortality rate were higher in group 1 than groups 2 and 3 ( p  < .05). The activities of daily living evaluated by Barthel Index (BI) three months' post-operation was significantly lower in group 3 than other groups ( p  < .05) and group 2 had the highest proportion of good outcomes. Among the patients with the hematoma volumes of 50-80 mL, the rebleeding risk was higher in group 1 than groups 2 and 3 ( p  < .05). However, there were no significant differences in mortality rates among these three groups. Moreover, group 1 had significantly higher BI than groups 2 and 3 ( p  < .05).
Conclusions: Minimally invasive surgery is safe and effective in patients with sICH. 6-12 h after sICH onset is the optimal surgical window for patients with hematoma volumes of 30-50 mL, while ultra-early (≤6 h) may achieve better results in patients with hematoma volumes of >50 mL.
Databáze: MEDLINE
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