Efficacy analysis of neuronavigation combined with endoscope-assisted microsurgery via retrosigmoid approach for primary pontine hemorrhage
WANG Shuangbao
ZHAO Weiran
ZHAO Jiankai
ZHANG Fei
FENG Guoqiang
Abstract：Objective To investigate the clinical efficacy of neuronavigation combined with endoscope-assisted microsurgery via the retrosigmoid approach for primary pontine hemorrhage.Methods The clinical data of 60 patients with primary pontine hemorrhage were analyzed retrospectively.Among them,30 patients underwent microsurgical treatment via the retrosigmoid approach with neuronavigation and endoscopic assistance(surgical group),while 30 patients received conservative treatment(control group).The hematoma evacuation rate or spontaneous hematoma absorption rate,complications,modified Rankin Scale(mRS)scores,and changes in serum inflammatory markers,including interleukin(IL)-6 and S100 calcium-binding protein β(S100β),were compared between the two groups.Results The hematoma evacuation rate at 72 hours postoperatively in the surgical group was(92.3±6.5)%,whereas the spontaneous absorption rate in the conservative group was(45.6±12.3)%.The incidence of stress ulcers was 3.33%(1/30)in the surgical group versus 26.67%(8/30)in the conservative group,and the incidence of severe pneumonia was 10.00%(3/30)in the surgical group versus 33.33%(10/30)in the conservative group,with statistically significant differences(both P<0.05).A favorable prognosis(mRS 0-2)was observed in 15 patients(50.00%)in the surgical group and 5 patients(16.67%)in the conservative group,with a statistically significant difference(P<0.05).Serum IL-6 and S100β levels at 72 hours post-treatment were significantly lower in the surgical group than in the conservative group(both P<0.05).Logistic regression analysis revealed that conservative treatment significantly increased the risk of poor prognosis compared with surgical treatment(OR=11.034,95%CI:1.610-75.639,P=0.015).Additionally,an elevated intracerebral hemorrhage score was associated with an increased risk of poor prognosis(OR=5.279,95%CI:1.412-19.737,P=0.013).Conclusions Neuronavigation combined with endoscope-assisted microsurgery via the retrosigmoid approach for primary pontine hemorrhage effectively suppresses inflammatory responses,improves neurological function,and significantly reduces the risk of systemic complications,demonstrating favorable therapeutic efficacy.
Keywords：brain stem hemorrhageprimaryretrosigmoid approachhematoma evacuation rateneurological outcomeinflammatory marker
Publication Date：2025-10-20
Online Publishing Date：2025-12-01(First online date of this platform, not the publication date of the document)
Pages：6( 574-579 )