Abstract
ObjectiveThis study aimed to determine the safety and effectiveness of DTI-assisted neuroendoscopy for treating intracranial hemorrhage (ICH).MethodsThis retrospective study included clinical data from 260 patients with spontaneous supratentorial ICH who received neuroendoscopic hematoma removal. Patients were separated into groups based on the surgery method they received: DTI-assisted neuroendoscopy (69 cases) and standard neuroendoscopy (191 cases). All patients were followed up for 6 months. Multivariate logistic regression analyzed the risk factors affecting the prognosis of patients. The outcomes of the two groups were compared using Kaplan–Meier survival curves.ResultsThe prognostic modified Rankin Scale (mRS) score was significantly better (P = 0.027) in the DTI-assisted neuroendoscopy group than in the standard neuroendoscopy group. Logistic regression analysis showed that DTI-assisted neuroendoscopy is an independent protective factor for a favorable outcome (model 1: odds ratio [OR] = 0.42, P = 0.015; model 2: OR = 0.40, P = 0.013). Kaplan–Meier survival curves were used to show that the median time for a favorable outcome was 66 days (95% confidence interval [CI] = 48.50–83.50 days) in the DTI-assisted neuroendoscopy group and 104 days (95% CI = 75.55–132.45 days) in the standard neuroendoscopy group. Log-rank testing showed that the DTI-assisted neuroendoscopy group had a lower pulmonary infection rate (χ 2 = 4.706, P = 0.030) and a better prognosis (χ 2 = 5.223, P = 0.022) than the standard neuroendoscopy group. The survival rate did not differ significantly between the DTI-assisted neuroendoscopy group and the standard neuroendoscopy group (P > 0.05).ConclusionsThe use of DTI in neuroendoscopic hematoma removal can significantly improve neurological function outcomes in patients, but it does not significantly affect the mortality of patients.
Highlights
intracranial hemorrhage (ICH) accounts for 10–20% of strokes in Western countries and 18.8–47.6% of strokes in China [1]
The Surgical Treatment for Intracerebral Hemorrhage (STICH) I and II trials [3,4] found that routine craniotomy did not improve the neurological function outcomes or reduce mortality
There were no significant differences between the two surgical interventions in sex, age, past medical history, laboratory parameters, hematoma volume, whether the hematoma broke into the ventricle, length of hospital stay, or the GCS score at admission
Summary
ICH (intracranial hemorrhage) accounts for 10–20% of strokes in Western countries and 18.8–47.6% of strokes in China [1]. The Surgical Treatment for Intracerebral Hemorrhage (STICH) I and II trials [3,4] found that routine craniotomy did not improve the neurological function outcomes or reduce mortality. The mortality rate of patients has decreased, but their neurological function outcomes have not been significantly improved through this method [8,9]. It is still worth investigating how the prognosis of patients with ICH can be improved, and how to reduce the social burden of this condition
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