Analysis of the curative effect and influencing factors of stereotactic aspiration in the treatment of primary brainstem haemorrhage

Yan, Li; Wu, Dongxue; Liu, Jianfeng; Li, Hui; Wang, Jiwei; Li, Ya-Xiong; Guo, Hao; Liu, Wei; Ji, Le; Chen, Ling-You; Zhang, Wenhua; Jing, Shanquan; Xu, Liang; Wang, Zi-Feng; Li, Conghui

doi:10.1016/j.jocn.2021.04.014

Cited by 5 publications

(10 citation statements)

References 22 publications

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“…However, Ichimura et al ( 18 ) reported an encouraging outcome in 5 HBSH patients of surgical management via the lateral or midline suboccipital and trans-rhomboid fossa approach. Currently, surgical treatments for HBSH is common in China ( 1 , 15 , 22 , 32 ). The high incidence of HBSH in China as well as East Asia is one of the reasons; another reason is that the traditional Chinese family and clan culture in addition to medical insurance policies determine the surgical treatment decision by a patient’s relatives, even if they are informed of unfavorable outcomes of undergoing surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Stereotactics have the function of accurate three-dimensional spatial positioning such that the surgeon can accurately reach the millimeter level of anatomy or lesion location in the brain through only a small channel. Therefore, minimally invasive stereotactic surgery has been applied for brainstem hemorrhage surgery, with encouraging results since 1989 ( 6 , 17 , 22 , 23 ). As an accurate auxiliary tool for surgical location, the robot stereotactic system is used in intracerebral hematoma puncture in addition to stereoelectroencephalogra-phy (SEEG) implantation and deep-brain stimulation (DBS) ( 24–26 ).…”

Section: Introductionmentioning

confidence: 99%

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Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Tang,

Huang,

Chen

et al. 2024

Front. Neurol.

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ObjectiveSpontaneous hypertensive brainstem hemorrhage (HBSH) is characterized by sudden onset, rapid progression and poor prognosis. There has been a growing tendency of surgical treatment for HBSH. This study aimed to investigate outcomes and potential factors associated with the prognosis of robot-assisted drainage surgery for HBSH treatment.MethodsPatients with HBSH from July 2016 to March 2023 at a single neurosurgery center were included and divided into conservative group and surgical groups. Baseline and clinical data, radiographic characteristics, complications, and outcome evaluations were recorded and analyzed.ResultsA total of 125 patients, with 74 in the conservative group and 51 in the surgical group, were enrolled in the study. Mortality at 6 months was 59/74 (79.7%) in the conservative group and 9/51 (17.6%) in the surgical group. Twenty-four patients (47.1%) achieved favorable outcomes in the surgical group, whereas this rate in the conservative group was only 5.4% (4/74). There was a significant difference in NIHSS, GCS, and mRS at 6 months between surviving patients in the conservative and surgical groups. In prognostic analysis in the surgical subgroup, initial GCS score [5 (IQR 4–7) vs. 3 (IQR 3–4), p < 0.001], NIHSS [36 (IQR 32–38) vs. 40 (IQR 38–40), p < 0.001], smoking history [45.8% (11/24) vs. 74.1% (20/27), p = 0.039], hematoma volume [6.9 (IQR 6.2–7.6) vs. 9.6 (IQR 7.3–11.4), p = 0.001], and hemorrhage location (p = 0.001) were potential risk factors for poor 6-month prognosis after robot-assisted surgery for HBSH.ConclusionBased on the results of this study, robot-assisted minimally invasive drainage of brain stem hematoma may significantly reduce mortality and improve prognosis. Surgery should be conducted for selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Tang,

Huang,

Chen

et al. 2024

Front. Neurol.

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“…The mortality rate of SBH varies greatly due to differences in the bleeding site and quantity; however, the prognosis of the majority of patients remains markedly poor (4,10). The treatment of SBH is usually conservative or surgical (craniotomy, puncture or drainage), which remains controversial (11,12). The majority of patients with SBH who are hospitalised choose conservative medical treatment due to unstable vital signs, high surgical and complications, high costs, and lack of large-sample, high-level, evidence-based assessment of surgical efficacy (13).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous brainstem haemorrhage in a patient with uraemia undergoing initial hemodialysis: A case report

Jia

Guo

2023

Exp Ther Med

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The present study reports the case of an elderly male inpatient with uraemia who had a sudden onset of numbness and weakness in the right limbs during sleep at night, accompanied by blurred and double vision, during the induction of haemodialysis (HD). Cranial computed tomography and magnetic resonance imaging revealed signs of brainstem haemorrhage. Consequently, a proactive treatment approach was adopted for decreasing the blood and intracranial pressures of the patient, and regular HD was continued. The condition of the patient improved, and the limbs showed no impairment of sensation, with normal movement. To the best of our knowledge, this is the first reported case of an inpatient with uraemia undergoing HD who developed a sudden brainstem haemorrhage during the induction phase of HD and completely recovered after conservative treatment. This unusual case deserves the attention of all clinicians, who should pay more attention to the patients with spontaneous brainstem hemorrhage.

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“…Therefore, microscopic craniotomy for hematoma removal can be considered an alternative treatment for primary brainstem hemorrhage. In China, reports on the surgical treatment of brainstem hemorrhage have gradually increased, and the prognosis in certain conditions has improved over recent years ( 7 , 17 , 18 ). Although surgical treatment cannot reverse the primary damage, the early release of hematoma compression and hemorrhagic inflammatory stimulation can effectively reduce the secondary damage and improve the prognosis of patients.…”

Section: Discussionmentioning

confidence: 99%

Laser Navigation Combined With XperCT Technology Assisted Puncture of Brainstem Hemorrhage

et al. 2022

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BackgroundBrainstem hemorrhage has a rapid onset with high mortality and disability rates. In recent years, an increasing number of studies have reported on the surgical treatment of brainstem hemorrhage. The introduction of stereotaxic instruments and navigation systems has improved the accuracy of surgical treatment; however, the popularity of these devices in the primary hospitals is not high. In this study, we introduce laser navigation combined with the XperCT technology to assist in the puncture and drainage of brainstem hemorrhage, aiming to improve surgical accuracy and facilitate the drainage of brainstem hemorrhage in primary hospitals.Material and MethodsA total of five patients (four men and one woman), aged 34–70 years, who underwent hematoma puncture drainage with the assistance of laser navigation combined with XperCT technology at the Binzhou Medical University Hospital, China, between June 2020 and Aug 2021 were included in the study. The brainstem hemorrhages had volumes of 7–18 ml. Statistical analyses of the postoperative puncture deviation distance (distance between the actual puncture end and simulated puncture end) and postoperative improvement were also performed.ResultsThe operations were successfully completed in all five patients. The puncture deviation distance was <6 mm in all five patients and <2 mm in two patients. The postoperative hematoma clearance rate was about 70%−90%. Among four patients with respiratory failure, three had improved breathing and resumed spontaneous breathing. Out of three patients with high fever, one showed a substantial decrease in body temperature. There were no cases of postoperative infection. Of the five patients, two recovered consciousness, one died, and two voluntarily gave up further treatment and were discharged.ConclusionsLaser navigation combined with the XperCT technology could improve the accuracy of surgical puncture. The technique might be convenient for widespread clinical application because of its low trauma, high precision, short operation time, and low operation cost.

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Analysis of the curative effect and influencing factors of stereotactic aspiration in the treatment of primary brainstem haemorrhage

Cited by 5 publications

References 22 publications

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Spontaneous brainstem haemorrhage in a patient with uraemia undergoing initial hemodialysis: A case report

Laser Navigation Combined With XperCT Technology Assisted Puncture of Brainstem Hemorrhage

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