The value of minimally invasive puncture and drainage in corticospinal tract Wallerian degeneration hypertensive intracerebral hemorrhage
ZHU Jianguo
HAN Jingzhe
CAO Duanhua
WANG Hongmei
KANG Zhilei
Abstract：Objective The purpose of this study was to observe whether minimally invasive puncture and drainage (MIPD) for the removal of intracranial hematoma can reduce the incidence of corticospinal tract Wallerian degeneration (CST WD),improve outcomes,and to analyze the impact factors of CST-WD,ultimately serving the clinic with the knowledge.Methods Two hundred and thirty-six patients confirmed within 24 hours of hypertensive basal ganglia hemorrhage (30-60 ml) were enrolled into the analysis.225 patients completed the test,they were assigned to receive MIPD (group A) or conservative treatment (group B).On day 7 and 14,the patients received MRI to evaluate the incidence of CST-WD from the DWI/ADC.The impact factors of cerebral hemorrhage CST-WD were investigated by statistical analysis.In addition,the follow-up records and NIHSS score were used to predicate the prognosis of the two types of treatment methods.Results The average hospitalization time of group A was less than group B (t =16.24,P =0.032);The incidence of CST-WD in group A was less than that in group B(x2 =10.174,P =0.001).Multivariate logistic regression analysis showed that the CST-WD was associated with the treatment methods(P =0.001) and bleeding sites (P =0.005).Six months after treatment,the total effective rate of Group A was significantly higher than that of Group B (83.9％ vs.62.9％,x2 =12.142,P ＜ 0.01).Conclusion For patients with hypertensive spontaneous ICH,MIPD may be a more effective treatment than conventional intervention,as indicated by higher reduction of CST-WD and better prognosis of the patients.However,for internal capsule hemorrhage,MIDP had a limited effect of reducing CST-WD.
Keywords：Wallerian DegenerationMinimally invasive puncture and drainageDiffusion-weighted imagingIntracerebral hemorrhagePrognosis
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 433-436,441 )