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

Abstract

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.