The effect of early vs. late CT-guided stereotactic hematoma aspiration on neurological function recovery in patients with hypertensive cerebral hemorrhage in the basal ganglia: a retrospective comparative cohort study.

Abstract

Surgery plays a major role in treating hypertensive cerebral hemorrhage in the basal ganglia; however, some patients suffer from neurological impairment after surgery. Studies have confirmed that stereotactic hematoma aspiration guided by computed tomography (CT) has significant value for patients with hypertensive intracerebral hemorrhage in the basal ganglia, but little is known about the optimal timing for the operation. This study sought to explore the effect of CT-guided stereotactic hematoma aspiration timing on the recovery of neurological function in patients with hypertensive cerebral hemorrhage in the basal ganglia. The data of 110 patients with hypertensive cerebral hemorrhage in the basal ganglia admitted to the Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2021 to December 2021 were retrospectively collected. Based on the timing of their operations, the patients were allocated to the early treatment group (within 24 hours, n=50) and late treatment group (after 24 hours, n=60). The postoperative recovery of the 2 groups was compared. There were no significant differences in terms of age, gender, amount of cerebral hemorrhage, hemorrhage ruptured into ventricle rate, Glasgow Coma Scale score, hypertension grade, hyperlipidemia, diabetes, and operation duration between the 2 groups (P>0.05). Additionally, there was no difference in the preoperative National Institute of Health Stroke Scale scores of the patients in the 2 groups (22.50±4.90 vs. 23.83±5.35, P=0.179). Compared to the late treatment group, the National Institute of Health Stroke Scale score of the patients in the early treatment group was significantly lower 3 and 6 months after the operation (5.90±4.02 vs. 9.23±3.47, P<0.001; 4.54±2.56 vs. 6.50±3.07, P<0.001, respectively). The Glasgow Outcome Scale score of patients in the early treatment group was significantly better than that of patients in the late treatment group (P=0.035). No significant difference was found in the incidence of postoperative pulmonary infection, intracranial infection, rebleeding, and lower extremity deep venous thrombosis between the 2 groups (P>0.05). Early CT-guided stereotactic hematoma aspiration may improve the postoperative neurological function of patients with hypertensive cerebral hemorrhage in the basal ganglia.