The initial CT blend sign is not associated with poor patient outcomes after stereotactic minimally invasive surgery

BMC Neurol. 2021 Apr 15;21(1):160. doi: 10.1186/s12883-021-02181-0.

Abstract

Background: The initial CT blend sign is an imaging marker that has been used to predict haematoma expansion and poor outcomes in patients with small-volume intracerebral haemorrhage (ICH). However, the association of the blend sign with the outcomes of patients undergoing surgery remains unclear. The present study aimed to retrospectively evaluate the influence of the initial CT blend sign on short-term outcomes in patients with hypertensive ICH after stereotactic minimally invasive surgery (sMIS).

Methods: We enrolled 242 patients with spontaneous ICH. The patients were assigned to the blend sign group (91 patients) or non-blend sign (control) group (151 patients) based on the initial CT features. The NIHSS, GCS and mRS were used to assess the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups.

Results: Statistically significant differences in the NIHSS and GCS scores were not observed between the blend sign group and the control group. No significant differences in the proportion of patients with good outcomes during the follow-up period were observed between the two groups. A higher rate of re-haemorrhage was noted in the blend sign group. Significant differences in the rates of severe pulmonary infection and cardiac complications were not observed between the two groups.

Conclusions: The initial CT blend sign is not associated with poor outcomes in patients with hypertensive ICH after sMIS. ICH patients with the CT blend sign should undergo sMIS if they are suitable candidates for surgery.

Keywords: Glasgow coma scale; Intracerebral haemorrhage; National Institute of health stroke scale. Blend signs; Stereotactic minimally invasive surgery.

MeSH terms

  • Aged
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / diagnostic imaging*
  • Cerebral Hemorrhage / surgery*
  • Female
  • Hematoma / diagnostic imaging*
  • Hematoma / etiology
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neuroimaging / methods*
  • Retrospective Studies
  • Stereotaxic Techniques*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome