Assessment of the effect of short-term factors on surgical treatments for hypertensive intracerebral haemorrhage

Clin Neurol Neurosurg. 2016 Nov:150:67-71. doi: 10.1016/j.clineuro.2016.08.023. Epub 2016 Aug 23.

Abstract

Background: Hypertension is the most common cause of intracerebral haemorrhages (ICHs), yet the short-term impact factors associated with hypertensive intracerebral haemorrhages (HICHs) in patients who undergo different surgical treatments are still unknown.

Materials and methods: All consecutive patients with acute HICHs admitted to our hospital from January 2012 to March 2015 were enrolled in the study. Patients were either randomly divided or assigned according to their family's preference into three groups (those undergoing minimally invasive aspiration, keyhole craniotomy or haematoma aspiration with extended pterional and decompressive craniotomy). Patients' information and clinical characteristics were collected to identify risk factors influencing the short-term effects of the procedures.

Results: There were significant differences among the groups: haematoma aspiration with extended pterional and decompressive craniotomy was the optimal method, resulting in fewer complications, higher Glasgow Outcome Scale (GOS) scores and better short-term outcomes. Surgical treatment, Glasgow Coma Scale (GCS) scores, haemorrhage volume and degree of midline shift were risk factors for the short-term effects associated with HICH.

Conclusions: Haematoma aspiration with extended pterional and decompressive craniotomy is suitable for treating HICH patients. Surgical treatment, GCS score, haemorrhage volume and degree of midline shift influence the short-term effects observed following HICH surgery.

Keywords: HICH; Impact factors; Short-term effect; Surgical treatments.

MeSH terms

  • Adult
  • Aged
  • Craniotomy / adverse effects
  • Craniotomy / methods*
  • Decompressive Craniectomy / adverse effects
  • Decompressive Craniectomy / methods
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale*
  • Hematoma / diagnostic imaging
  • Hematoma / surgery*
  • Humans
  • Intracranial Hemorrhage, Hypertensive / diagnostic imaging*
  • Intracranial Hemorrhage, Hypertensive / surgery*
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care*
  • Postoperative Complications*