Perihematomal edema after minimally invasive surgery: A matter of concern to Neurosurgeon

Abstract

Background and purpose To explore the evolution of brain edema after minimally invasive surgery (MIS) in deep spontaneous cerebral hemorrhage (DSICH) treatment and to analyze the differences in edema after different surgical methods. Methods The clinical data of 92 patients with DSICH treated in Renmin Hospital of Wuhan University from January 2020 to December 2021 were analyzed retrospectively. Among them, 47 cases were treated with minimally invasive puncture and drainage surgery (MIPDS group), and 45 were treated with neuroendoscopic surgery (NES group). The continuous Computed Tomography (CT) images of patients in the hospital and 3D-Slicer software were used to quantitatively calculate the edema area to explore the changes in perihematomal edema(PHE) volume in the two groups after the operation. Results The peak volume of postoperative edema (37.68 ± 10.74 mL) in the MIPDS group was more extensive than that of the NES group, and the net increase in edema volume was 17.47 ± 10.15 mL more than that of the NES group. The relative edema index (0.87 ± 0.27) was lower in the NES group than in the MIPDS group. (P < 0.05). The peak of postoperative edema in the MIPDS group was more than that in 6–8 days after the operation, and that in the NES group was more than that in 3–5 days after the operation. Conclusion There are differences in perihematomal edema of DSICH treated by different minimally invasive methods. Compared with MIPDs group, NEs group showed earlier peak of cerebral edema and lower degree of cerebral edema. The absolute regression volume of edema in the MIDPs group was greater than that in the NEs group, but there was no difference in the regression rate of edema between the two groups.