Analysis of efficacy and postoperative rebleeding after stereotactic frontal and occipitoparietal approaches for hypertensive intracerebral hemorrhage
Li Xiang
Wang Lan
Yan Xinjiang
Mao Dandan
Liu Wei
Xu Yongming
Zhou Richeng
Fang Min
Abstract：Objective To investigate the efficacy and postoperative rebleeding of stereotactic-assisted frontal and occipitoparietal approaches in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 190 patients with HICH who underwent hematoma evacuation were recruited and divided into a control group(92 cases)and a study group(98 cases)based on different surgical approaches.The control group underwent stereotactic-assisted occipitoparietal approach surgery,while the study group underwent stereotactic-assisted frontal approach procedure.Clinical indicators,postoperative complications,and Activities of Daily Living(ADL)scores were compared between the two groups.Multivariate logistic regression analysis was performed to identify risk factors for HICH.Results No significant differences were observed between the two groups in terms of gender,age,and location of hemorrhage(P>0.05).Compared with the control group,the study group had a higher hematoma evacuation rate,less intraoperative blood loss,shorter operative time,hospitalization duration,and ICU stay,as well as a lower incidence of postoperative complications(P<0.05).The study group also had a higher proportion of patients with ADL grades Ⅰ and Ⅱ and a lower proportion of patients with grades Ⅲ and Ⅳ after surgery(P<0.05).Univariate analysis revealed that postoperative rebleeding in HICH patients was not associated with gender,age,underlying comorbidities,or the use of analgesic and sedative medications(P>0.05).Univariate analysis and multivariate logistic regression analysis revealed that systolic blood pressure>160 mmHg,diastolic blood pressure>90 mmHg,preoperative hematoma volume>30 ml,preoperative GCS score<10,and occipitoparietal approach were the risk factors for postoperative rebleeding in HICH patients(all P<0.05).Conclusions Stereotactic-assisted frontal approach for hematoma evacuation in HICH patients would result in more significant improvement in clinical symptoms and a lower incidence of complications.Systolic blood pressure,diastolic blood pressure,preoperative hematoma volume,preoperative GCS score,and surgical approach are factors influencing postoperative rebleeding in HICH patients.
Keywords：cerebral hemorrhagehypertensivestereotaxic techniquesfrontal approachoccipital-parietal approach
Publication Date：2024-08-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 453-457 )