An effective treatment for cerebral hemorrhage: minimally invasive craniopuncture combined with urokinase infusion therapy

Sun, Haixin; Liu, Hongmei; Li, Di; Liu, Liping; Yang, Jun; Wang, Wenzhi

doi:10.1179/016164110x12670144526147

Cited by 63 publications

(34 citation statements)

References 16 publications

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“…The majority of scholars believed that surgical treatments, including MIS and craniotomy, are suitable for patients with SICH with a hematoma volume of ≥30 mL. 10,15,22 In this subgroup analysis, MIS of hematoma volume ≥25 and ≤40 mL were both significantly better as far as primary outcome than other treatment options. Thus, we think the patients with hematoma volume between 25 and 40 mL would benefit most from MIS; however, because only few studies used this limit, the validity of this analysis is limited.…”

Section: Strokementioning

confidence: 71%

“…1,19,20 In addition, we also participated in a prospective randomized controlled study, which compared the effectiveness of minimally invasive stereotactic puncture therapy versus conventional craniotomy in SICH. 10 Recently, several large RCTs on the management of SICH have been published, 21,22 and there is an urgent need for additional systematic review to assist clinicians in establishing an optimal treatment strategy.…”

Section: Strokementioning

confidence: 99%

See 1 more Smart Citation

Minimally Invasive Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage

Zhou

Chen²,

Li³

et al. 2012

Stroke

191

119

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Background and Purpose— There has been a nonstandard surgical procedure and extensive international controversy in minimally invasive surgery (MIS) for the management of spontaneous supratentorial intracerebral hemorrhage. This meta-analysis assessed the effectiveness of MIS as compared with other treatment options, including conservative medical treatment and conventional craniotomy, in patients with supratentorial intracerebral hemorrhage. Methods— PubMed, Embase, Cochrane Controlled Trials Register (CCTR), Web of Science, European Association for Grey Literature Exploitation (EAGLE), National Technical Information Service (NTIS), Current Controlled Trials, Clinical Trials, International Clinical Trials Registry, Internet Stroke Center, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI) (last searched December 2011) were searched. Randomized controlled trials on MIS in patients with computed tomography-confirmed supratentorial intracerebral hemorrhage were included. We excluded low-quality randomized controlled trials. The death or dependence at the end of follow-up was defined as the primary outcome, and the death at the end of follow-up was defined as the secondary outcome. Results— The 313 randomized controlled trials met the included criteria. We only analyzed 12 high-quality randomized controlled trials involving 1955 patients. The quality of the included trials was consistently high. OR of the primary outcome and secondary outcome of MIS both showed significant reductions (OR, 0.54, P <0.00001; OR, 0.53, P <0.00001). Conclusions— Patients with supratentorial intracerebral hemorrhage may benefit more from MIS than other treatment options. The most likely candidates to benefit from MIS are both sexes, age of 30 to 80 years with superficial hematoma, Glasgow Coma Scale score of ≥9, hematoma volume between 25 and 40mL, and within 72 hours after onset of symptoms. Our study could help select appropriate patients for MIS and guide clinicians to optimize treatment strategies in supratentorial intracerebral hemorrhage.

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Section: Strokementioning

confidence: 71%

Section: Strokementioning

confidence: 99%

Minimally Invasive Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage

Zhou

Chen²,

Li³

et al. 2012

Stroke

191

119

View full text Add to dashboard Cite

show abstract

“…MIS causes less violation of the cortex and white matter tracts, and decreased operative duration and blood loss compared to conventional surgical approaches, which may reduce surgical morbidity and accelerate the postoperative recovery process. Early randomized trials have shown evidence that supports the efficacy of these techniques, but the results are inconclusive as to which MIS technique is best [29][30][31][32][33][34][35][36]. However, a recent meta-analysis by Zhou et al found that MIS for ICH was associated with a significantly lower rate of death or functional dependence compared to medical management or conventional craniotomies (p < 0.00001) [37].…”

Section: Discussionmentioning

confidence: 98%

Endoport-assisted surgery for the management of spontaneous intracerebral hemorrhage

Przybylowski

Ding

Starke

et al. 2015

Journal of Clinical Neuroscience

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“…It was suggested as a safe and practical technique for the treatment of ICH [8]. Tan Q et al reported that in comparison with tissue-type plasminogen activator, urokinase-type plasminogen activator (uPA) better ameliorated brain edema and promoted an improved outcome after ICH, uPA therapy more effectively upregulated BBB tight junction protein expression [36].…”

Section: Research Guofeng Wu Mengzhou Xuementioning

confidence: 99%

“…MIS is a safe and practical technique in treating ICH. Patients with ICH may be benefit more from MIS than other treatment options [6][7][8][9]. Although MIS could effectively evacuate blood clot and reduce the brain damage following ICH, but does not completely remove the erythrocytes and cytotoxic substances which extravasate into the adjacent brain [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Surgery for Intracerebral Hematoma Evacuation followed by Rosiglitazone Infusion Therapy Increased Perihematomal Occludin, Zonula Occludens-1 Expression and Decreased the Blood Brain Barrier Permeability in Rabbits

Ren¹,

Wu²,

Huang³

et al. 2018

Neuropsychiatry

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Objective: To observe the effects of minimally invasive surgery (MIS) for hematoma of intracerebral hemorrhage (ICH) evacuation followed by rosiglitazone (RSG) infusion therapy on perihematomal tight junction associated proteins occludin and zonula occludens-1 (ZO-1) expression as well as blood brain barrier (BBB) permeability in rabbits.Methods: A total of 50 male rabbits (2.5-3.5 kg) were randomly assigned to a sham group (Sham group, 10 rabbits), an ICH model group (HM group, 10 rabbits), a RSG medication group (RSG group, 10 rabbits), a minimally invasive surgery group (MIS group, 10 rabbits) and a MIS combined with RSG group (MIS+RSG group, 10 rabbits). ICH was induced in all of the rabbits except for those in the Sham group. An MIS was performed to evacuate the hematoma at 6 hours after the successful preparation of the ICH model in the MIS group and the MIS+RSG group. The RSG (0.5mg, dissolved in 0.1 ml of 0.9% sodium chloride solution) was infused into the hematoma area in the RSG group and the MIS+RSG group. All rabbits were sacrificed on day 7 after the relative processes were performed successfully, and the perihematomal brain tissue was removed to determine the occludin and ZO-1 expression and BBB permeability by Evens Blue (EB). Results:The occludin and ZO-1 expression were all significantly decreased and the BBB permeability was increased in the HM group compared with the Sham group. The RSG used alone or performing the MIS alone to evacuate the ICH resulted in a marked increase in the occludin and ZO-1 expression and decrease in BBB permeability. The MIS+RSG group displayed a great increase in the occludin and ZO-1 expression and a more significant decrease in BBB permeability. Conclusions:The MIS combined with RSG medication could significantly increase the perihematomal occludin and ZO-1 expression and decrease in BBB permeability which plays an important therapeutic role in secondary brain damage following ICH. KeywordsIntracerebral hemorrhage, Minimally invasive surgery, Rosiglitazone, Tight junction, Occludin, Zonula occludens-1, Blood-brain barrier Rosiglitazone (RSG), an agonist of peroxisome proliferator-activated receptor-gamma (PPARγ), has shown neuroprotective effects in patients with ischemic stroke and Alzheimer's disease. It has reported that RSG could significantly reduce brain tissue loss, ameliorated white matter injury, and improved sensorimotor and cognitive functions and increased the numbers of newly generated mature oligodendrocytes after middle cerebral artery occlusion [24]. RSG reversed depressive behaviors in mice, as indicated by the forced swimming test and open field test. RSG was also found to inhibit the inflammatory response, decrease corticosterone levels, promote astrocyte proliferation and neuronal axon plasticity in the prefrontal cortex of mice, and exerts an antidepressive effect in unpredictable chronic mildstress-induced depressive mice by maintaining essential neuron autophagy and inhibiting excessive astrocytic apoptosis [25]. Several studies have ...

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An effective treatment for cerebral hemorrhage: minimally invasive craniopuncture combined with urokinase infusion therapy

Cited by 63 publications

References 16 publications

Minimally Invasive Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage

Minimally Invasive Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage

Endoport-assisted surgery for the management of spontaneous intracerebral hemorrhage

Minimally Invasive Surgery for Intracerebral Hematoma Evacuation followed by Rosiglitazone Infusion Therapy Increased Perihematomal Occludin, Zonula Occludens-1 Expression and Decreased the Blood Brain Barrier Permeability in Rabbits

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