Stereotactic Puncture Surgery for the Treatment of Moderate Volume of Thalamus-Internal Capsule Area Hemorrhage: An Analysis of Real-World Data

Shiqiang Yang; Yanwei Liu; Shiqiang Wang; Hua Peng; Hongtao Luo; Zhonghai Cai; Xuhui Hui; Anqiang Yang

doi:10.1016/j.wneu.2024.03.107

Stereotactic Puncture Surgery for the Treatment of Moderate Volume of Thalamus-Internal Capsule Area Hemorrhage: An Analysis of Real-World Data

World Neurosurg. 2024 Mar 26:S1878-8750(24)00492-3. doi: 10.1016/j.wneu.2024.03.107. Online ahead of print.

Authors

Shiqiang Yang¹, Yanwei Liu², Shiqiang Wang³, Hua Peng⁴, Hongtao Luo⁴, Zhonghai Cai⁴, Xuhui Hui⁵, Anqiang Yang⁶

Affiliations

¹ Department of Neurosurgery, The First People's Hospital of Yibin City, Yibin, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
² Department of Neurology, The First People's Hospital of Yibin City, Yibin, China.
³ Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China.
⁴ Department of Neurosurgery, The First People's Hospital of Yibin City, Yibin, China.
⁵ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
⁶ Department of Neurosurgery, The First People's Hospital of Yibin City, Yibin, China. Electronic address: 717289270@qq.com.

PMID: 38537786
DOI: 10.1016/j.wneu.2024.03.107

Abstract

Background: The efficacy of surgical intervention in ameliorating long-term prognosis for moderate volume of cerebral hemorrhage in the thalamus-internal capsule region remains unsubstantiated by clinical investigations. Consequently, the acquisition of credible evidence is imperative to authenticate the effectiveness of these methodologies.

Methods: One hundred and three eligible patients with moderate-volume thalamus-internal capsule region cerebral hemorrhage. Twenty-seven pairs of successful matches after using the 1:1 propensity score matching method, totaling 54 patients, were analyzed. The short- and long-term treatment outcomes of patients in the stereotactic surgery and conservative treatment groups were compared. The prognosis of the 2 groups of patients was analyzed by logistic regression analysis and model comparison.

Results: The primary outcome of this study was to assess the assessment of daily living scores after 6 months of treatment. Based on the analysis of this study, the assessment of daily living of the surgical group were significantly higher than those of the conservative treatment group after 6 months of treatment (P < 0.001), and the difference was statistically significant. The amount of residual hematoma was significantly lower in the stereotactic surgery group than in the conservative treatment group at 3 days, 7 days, and 2 weeks after the onset of the disease (P < 0.001), and the complication rate was lower than the conservative treatment group (P < 0.05). Univariate logistic regression showed that the risk of severe neurological dysfunction for patients in the surgery group was (odds ratio -0.27, 95% confidence interval: 0.08-0.86, P < 0.05). In multivariate logistic regression analysis, the odds ratio was 0.29 (95% confidence interval: 0.09-0.96, P < 0.05) after adjusting for all covariates.

Conclusions: For moderate-volume thalamus-internal capsule region cerebral hemorrhage, stereotactic paracentesis has the advantage of a shorter hospital stay and a lower complication rate than conservative treatment. Moreover, it yields superior outcomes in terms of daily living assessment scores after six months of treatment and enhanced neurological recovery.

Keywords: Neurological deficits; Propensity score matching (PSM); Stereotactic puncture and drainage; Thalamus-internal capsule region hemorrhage.