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Ultrarapid Endoscopic-Aided Hematoma Evacuation in Patients with Thalamic Hemorrhage
Behavioural Neurology ( IF 2.7 ) Pub Date : 2021-01-21 , DOI: 10.1155/2021/8886004
Kuan-Yu Chen, Woon-Man Kung, Lu-Ting Kuo, Abel Po-Hao Huang

Thalamic hemorrhage bears the worst outcome among supratentorial intracerebral hemorrhage (ICH). Minimally invasive endoscopic-aided surgery (MIS) has been proved to be safe and effective in evacuating ICH. However, the ideal timing of MIS is still a controversy. In this study, we present our experience in the treatment of patients with thalamic hemorrhage by ultrarapid MIS evacuation. This retrospective analysis enrolled seven patients treated with ultrarapid MIS evacuation of thalamic hemorrhage. Seven patients treated with EVD with similar ICH score were included as match control. Primary endpoints included rebleeding, morbidity, and mortality. Hematoma evacuation rate was evaluated by comparing the pre- and postoperative computed tomography (CT) scans. Glasgow Outcome Scale Extended (GOSE) and modified Rankin Score (mRS) were noted at the 6-month and 1-year postoperative follow-up. Among the seven patients, six were accompanied with intraventricular hemorrhage. All patients received surgery within 6 hours after the onset of stroke. The mean hematoma volume was 35 mL, and the mean operative time was 116.4 minutes. The median hematoma evacuation rate was 74.9%. There was no rebleeding or death reported after the surgery. The median GOSE and mRS were 3 and 5, respectively, at 6 months postoperatively. Further, 1-year postoperative median GOSE and mRS were 3 and 5, respectively. The data suggest that the ultrarapid MIS technique is a safe and effective way in the management of selected cases with thalamic hemorrhage, with favorable long-term functional outcomes. However, a large, prospective, randomized-controlled trial is needed to confirm these findings.

中文翻译:

丘脑出血患者的超快速内镜辅助血肿清除术

在幕上脑出血 (ICH) 中,丘脑出血的预后最差。微创内窥镜辅助手术 (MIS) 已被证明在疏散 ICH 方面是安全有效的。然而,MIS的理想时机仍然存在争议。在这项研究中,我们介绍了我们通过超快速 MIS 清除治疗丘脑出血患者的经验。这项回顾性分析招募了 7 名接受超快速 MIS 清除丘脑出血的患者。7 名接受 EVD 治疗且 ICH 评分相似的患者被纳入作为匹配对照。主要终点包括再出血、发病率和死亡率。通过比较术前和术后计算机断层扫描 (CT) 扫描来评估血肿清除率。在术后 6 个月和 1 年的随访中记录了格拉斯哥结局量表扩展 (GOSE) 和改良 Rankin 评分 (mRS)。7例患者中,6例伴有脑室内出血。所有患者均在卒中发生后 6 小时内接受手术。平均血肿体积为 35 mL,平均手术时间为 116.4 分钟。血肿清除率中位数为 74.9%。手术后无再出血或死亡报告。术后 6 个月的中位 GOSE 和 mRS 分别为 3 和 5。此外,术后 1 年中位 GOSE 和 mRS 分别为 3 和 5。数据表明,超快速 MIS 技术是治疗选定的丘脑出血病例的一种安全有效的方法,具有良好的长期功能结果。然而,一个大型的、有前景的、
更新日期:2021-01-21
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