Minimally invasive approaches for the evacuation of intracerebral hemorrhage: a systematic review

Cavallo, Claudio; Zhao, Xiaochun; Abou‐Al‐Shaar, Hussam; Weiss, Miriam; Gandhi, Sirin; Belykh, Evgenii; Tayebi-Meybodi, Ali; Labib, Mohamed A.; Preul, Mark C.; Nakaji, Peter

doi:10.23736/s0390-5616.18.04557-5

Cited by 7 publications

(6 citation statements)

References 73 publications

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“…The results showed that the NIHSS score and the SSS score of the experimental group were 3:89 ± 1:95 points and 10:67 ± 1:76 points in the experimental group one month after the surgery, which were significantly lower than those of the control group, and the difference was statistically significant (P < 0:05). Cavallo et al [24] conducted a systematic review on the application of minimally invasive aspiration in ICH, and the results showed that minimally invasive technology is still in dispute in the treatment of ICH. However, many clinical studies have shown that minimally invasive treatment is associated with significantly improved results compared with conservative treatment and traditional surgical removal strategies.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Images under Artificial Intelligence Algorithms on the Treatment Evaluation of Intracerebral Hemorrhage with Minimally Invasive Aspiration

Sun

Zheng

Gao

et al. 2022

Computational and Mathematical Methods in Medicine

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The aim of this study was to investigate the therapeutic effect of minimally invasive aspiration on intracerebral hemorrhage (ICH) and the value of artificial intelligence algorithm combined with computed tomography (CT) image evaluation. Ninety-two patients with intracerebral hemorrhage were divided into experimental group (46 cases, minimally invasive aspiration therapy) and control group (46 cases, traditional craniotomy therapy) according to different treatment methods, and CT image scanning was performed. In addition, a CT image segmentation model of intracerebral hemorrhage based on improved fuzzy C-means clustering algorithm (n-FCM) was proposed to process the CT images of the patients. The results showed that the Dice coefficient of n-FCM algorithm after the addition of salt and pepper noise was 0.89, which was higher than that of traditional algorithm; the average operation time of experimental group was 58.93 ± 5.33 min, which was significantly lower than that of control group ( 90.21 ± 16.24 min) ( P < 0.05 ); the overall response rate of experimental group was 93.48%, which was significantly higher than that of control group (76.09%) ( P < 0.05 ); one month after operation, the National Institutes of Health Stroke Scale (NIHSS) score of experimental group was 3.89 ± 1.95 points, and the Scandinavian Stroke Scale (SSS) score was 10.67 ± 1.76 points, which was significantly lower than that of control group ( P < 0.05 ); the incidence rate of complications in experimental group was significantly lower than that of control group ( P < 0.05 ). It showed that the n-FCM algorithm was superior to the traditional algorithm in CT image processing, with the advantages of good denoising effect and less running time. Minimally invasive aspiration treatment had the advantages of operation time, convenient operation, and less damage to patients, which was beneficial to postoperative recovery and prognosis of patients.

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Section: Discussionmentioning

confidence: 99%

Computed Tomography Images under Artificial Intelligence Algorithms on the Treatment Evaluation of Intracerebral Hemorrhage with Minimally Invasive Aspiration

Sun

Zheng

Gao

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Main reason: When using the temporal approach to remove an intracerebral hematoma, it is easy to limit the direct viewing angle because of the consistency between the line of sight and the length of the hematoma, thereby reducing the hematoma clearance rate. [ 20 , 21 ] Even by adjusting the direction of neuroendoscopy and using angled neuroendoscopy to increase the visual range, the location of the hematoma can increase brain tissue damage, which is not conducive to disease progression, and the temporal approach is prone to transverse damage to the conduction tract. The line of sight and length of the hematoma in the frontal lobe approach are basically consistent and roughly parallel to the conduction tract, which provides better protection for the conduction tract than the temporal approach, improves neurological function, and ensures the effectiveness of disease prognosis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Wang,

Su,

Zhou

et al. 2024

Medicine

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We aimed to explore the therapeutic effects of endoscopically assisted surgical approaches for HICH. In this retrospective cohort study, we retrospectively analyzed the treatment status of 118 patients with HICH who underwent surgery for hematoma removal. Among them, 61 patients underwent endoscopically assisted hematoma removal surgery through the frontal lobe approach (frontal lobe group); 57 patients underwent endoscopic hematoma assisted via the temporal lobe approach (temporal lobe group). Treatment effects, cerebral hemodynamic status before and after treatment, postoperative prognosis at one month, and incidence of complications were compared between the 2 groups. We found that the total effective treatment rate in the frontal lobe group was higher than that in the temporal lobe group (P < .05). After surgery, the R during the contraction period of the common cerebral artery in both groups decreased compared to that before surgery, and the frontal lobe group was significantly lower than the temporal lobe group; the V and Q were higher than those before surgery, and the frontal lobe group was significantly higher than the temporal lobe group (P < .05). The prognosis of the frontal lobe group was better than that of the temporal lobe group (P < .05). Compared to the endoscopic-assisted temporal approach, the endoscopic-assisted frontal lobe approach for the treatment of HICH can improve cerebral hemodynamic status, enhance treatment efficacy, and improve prognosis.

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“…The lack of clear surgical benefit noted in the STICH trial may be attributed to the permanence of deficits upon BG hemorrhage as surgical intervention cannot restore what was lost. Most surgeons in the trial employed a craniotomy (75%), despite nearly 42% of hematoma originating within the BG or thalamus, raising questions as to whether a more minimally invasive surgical approach would lead to better outcomes [ 107 ]. Early surgery was associated with a slightly favorable outcome when the hematoma was located within 1 cm from the cortical surface, which may have been a reflection of the advantages of craniotomy for superficial resection, though when this subgroup was explored in a follow-up trial (STICH II) in 2013 [ 15 ], the findings remained neutral.…”

Section: Discussionmentioning

confidence: 99%

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

et al. 2023

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Bilateral basal ganglia hemorrhages (BBGHs) represent rare accidents, with no clear standard of care currently defined. We reviewed the literature on BBGHs and analyzed the available conservative and surgical strategies. PubMed, Scopus, Web of Science, and Cochrane were searched following the PRISMA guidelines to include studies reporting patients with BBGHs. Clinical characteristics, management, and outcomes were analyzed. We included 64 studies comprising 75 patients, 25 (33%) traumatic and 50 (67%) non-traumatic. Traumatic cases affected younger patients (mean age 35 vs. 46 years, p =0.014) and males (84% vs. 71%, p =0.27) and were characterized by higher proportion of normal blood pressures at admission (66% vs. 13%, p =0.0016) compared to non-traumatic cases. Most patients were comatose at admission (56%), with a mean Glasgow Coma Scale (GCS) score of 7 and a higher proportion of comatose patients in the traumatic than in the non-traumatic group (64% vs. 52%, p =0.28). Among the traumatic group, motor vehicle accidents and falls accounted for 79% of cases. In the non-traumatic group, hemorrhage was most associated with hypertensive or ischemic (54%) and chemical (28%) etiologies. Management was predominantly conservative (83%). Outcomes were poor in 56% of patients with mean follow-up of 8 months. Good recovery was significantly higher in the traumatic than in the non-traumatic group (48% vs. 17%, p =0.019). BBGHs are rare occurrences with dismal prognoses. Standard management follows that of current intracerebral hemorrhage guidelines with supportive care and early blood pressure management. Minimally invasive surgery is promising, though substantial evidence is required to outweigh the potentially increased risks of bilateral hematoma evacuation. Supplementary Information The online version contains supplementary material available at 10.1007/s10143-023-02044-x.

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Minimally invasive approaches for the evacuation of intracerebral hemorrhage: a systematic review

Cited by 7 publications

References 73 publications

Computed Tomography Images under Artificial Intelligence Algorithms on the Treatment Evaluation of Intracerebral Hemorrhage with Minimally Invasive Aspiration

Computed Tomography Images under Artificial Intelligence Algorithms on the Treatment Evaluation of Intracerebral Hemorrhage with Minimally Invasive Aspiration

Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

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