Efficacy study of neuronavigation-assisted stereotactic drilling of urokinase drainage versus craniotomy in the treatment of massive intracerebral haemorrhage in elderly patientsa

Ziwei Yan; Lai Jiang; Gang Li; Kailai Xia; Lei Peng; Jinyang Hu; Shaojun Chen; Jiayi Zhang; Xin Huang

doi:10.1038/s41598-024-71130-x

Scientific Reports (Sep 2024)

Efficacy study of neuronavigation-assisted stereotactic drilling of urokinase drainage versus craniotomy in the treatment of massive intracerebral haemorrhage in elderly patientsa

Ziwei Yan,
Lai Jiang,
Gang Li,
Kailai Xia,
Lei Peng,
Jinyang Hu,
Shaojun Chen,
Jiayi Zhang,
Xin Huang

Affiliations

Ziwei Yan: Department of Ultrasound Imaging, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Lai Jiang: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Gang Li: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Kailai Xia: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Lei Peng: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Jinyang Hu: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Shaojun Chen: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital
Jiayi Zhang: Basic Medical College of China Three Gorges University
Xin Huang: Department of Neurosurgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s Hospital

DOI: https://doi.org/10.1038/s41598-024-71130-x
Journal volume & issue: Vol. 14, no. 1
pp. 1 – 10

Abstract

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Abstract To evaluate the efficacy of neuronavigation-assisted stereotactic drilling drainage compared with that of craniotomy in the treatment of massive intracerebral haemorrhage (ICH) in elderly patients. This was a randomized, controlled, blind endpoint clinical study. Elderly patients with massive ICH treated at our neurosurgery department, without the formation of brain herniation preoperatively, all underwent neurosurgical intervention. Patients were randomly assigned to two groups: the minimally invasive surgery (MIS) group, which received neuronavigation-assisted stereotactic drilling drainage, and the craniotomy haematoma removal surgery (CHRS) group. Patient characteristics, surgical anaesthesia methods, surgery duration, intraoperative bleeding volume, duration of ICU stay duration of hospital stay, complications, and modified Rankin scale (mRS) scores at 90 days posttreatment were compared between the two groups. Statistical analysis was performed on the collected data. A total of 67 patients were randomly assigned, with 33 (49.25%) in the MIS group and 34 (50.75%) in the CHRS group. Compared with the CHRS group, the MIS group had advantages, including the use of local anaesthesia, shorter surgery duration, less intraoperative bleeding, shorter ICU stay, and fewer complications (P 0.05). For elderly patients with massive ICH without brain herniation, stereotactic drilling drainage is a simple surgical procedure that can be performed under local anaesthesia. Patients treated with this approach seem to have better outcomes than those treated with craniotomy. In clinical practice, neuronavigation-assisted stereotactic drilling drainage is recommended for surgical treatment in elderly patients with massive ICH without brain herniation. Clinical trial registration number: NCT04686877

Published in Scientific Reports

ISSN: 2045-2322 (Online)
Publisher: Nature Portfolio
Country of publisher: United Kingdom
LCC subjects: Medicine; Science
Website: https://www.nature.com/srep/

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