Comparison of the Outcomes of Neuroendoscopic Surgery for Thalamic Hemorrhage with Ventricular Extension in the Ultra-Early and Early Time
ZHOU Weijian
ZHAO Yajun
WANG Lei
LI Yue
ZHAO Shupeng
Abstract：Objective To investigate the effect of ultra-early(＜6 h)and early(6-24 h)neuroendoscopic surgery on patients with thalamic hemorrhage with ventricular extension and its influence on inflammatory factors,nerve injury factors and rebleeding risk.Methods The clinical data of 61 patients with thalamic hemorrhage with ventricular extension who underwent neuroendoscopic surgery in Henan Second People's Hospital from January 2024 to June 2025 were retrospectively analyzed.According to the timing of surgery,30 patients with onset to operation time＜6 h were included in the ultra-early group,and 31 patients with onset to operation time between 6 and 24 h were included in the early group.The routine indexes of operation and hematoma clearance were compared between the two groups,as well as the inflammatory indexes[C-reactive protein(CRP),white blood cell count,systemic immune inflammatory index(SII)],and neuron-specific enolase(NSE),S100β protein(S100β),matrix metalloproteinase-9(MMP-9)before operation,1 d and 3 d after operation.The complications during hospitalization and the modified Rankin scale(mRS)score within 3 months after operation were counted.Results The operation time of the ultra-early group was(129.86±21.40)min,which was longer than(102.75±26.96)min of the early group.The indwelling time of the external ventricular drainage tube and the hospitalization time were(6.53±1.27)d and(18.40±4.66)d,which were shorter than(8.01±1.64)d and(24.03±3.29)d of the early group(P＜0.05).The incidence of rebleeding and the total incidence of complications in the ultra-early group were 26.67％and 3.33％,respectively,compared with 6.45％and 12.90％in the early group,the difference was not statistically significant(P＞0.05).The complete clearance rate,near complete clearance rate and most clearance rate of hematoma in the ultra-early group were 70.00％,26.67％and 3.33％,respectively,which were better than 25.81％,58.06％,and 16.13％in the early group(P＜0.05).The CRP,white blood cell count and SII index of patients in the ultra-early group were lower than those in the early group at 1 d and 3 d after operation(P＜0.05).The levels of NSE,S100β and MMP-9 in the ultra-early group were lower than those in the early group at 1 d and 3 d after operation(P＜0.05).The good prognosis rate of patients in the ultra-early group was 86.67％,which was higher than 54.84％in the early group(P＜0.05).Conclusion For patients with thalamic hemorrhage breaking into the ventricle,neuroendoscopic ultra early surgery(＜6 hours)at the very early stage of the disease may increase the operation time and the risk of rebleeding compared with early surgery(6-24 hours),but it can be controlled through more thorough hematoma removal,secondary inflammation and nerve damage,without increasing the incidence of complications,and can shorten the recovery time and obtain better prognosis.
Keywords：thalamic hemorrhageneuroendoscopyultra-early onsethematoma removalcomplication
Publication Date：2026-08-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2952-2957 )