Efficacy of endoscopic frontal versus temporal approaches for hematoma evacuation in elderly patients with hypertensive intracerebral hemorrhage and effect on neurological function and inflammatory factors
YANG Jun
JIA Chuangchuang
JIN Xin
LIANG Qilong
ZHANG Hong
JIA Maolin
HE Jiaji
Abstract：Objective To compare and analyze the clinical efficacy of neuroendoscopic hematoma removal via frontal and temporal lobe approaches in the treatment of elderly patients with hypertensive intracerebral hemorrhage(HICH),and to explore the influence of two different approaches on neurological function and inflammatory factors.Methods Clinical data of 240 elderly HICH patients undergoing neuroendoscopic surgical treatment in our hospital from January 2019 to January 2024 were collected retrospectively.Based on the approaches for neuroendoscopic hematoma removal,the patients were divided into a frontal lobe group(115 cases,via frontal lobe approach)and temporal lobe group(125 cases,via temporal lobe approach).The clinical efficacy,inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),IL-6,TNF-α,IL-1 β,soluble triggering receptor expressed in myeloid cells-1(sTREM-1)],and neurological function indicators[brain-derived neurotrophic factor(BDNF),S100 calcium binding protein B(S100 B),nerve growth factor(NGF),neuron-specific enolase(NSE)]before and after surgery were compared between the two groups.National Institutes of Health Stroke Scale(NIHSS)score was used to evaluate neurological function.Prognosis at 1 month after surgery and occurrence of complications were observed and compared between the two groups.Results The total effective rate was significantly higher in the frontal lobe group than the temporal lobe group(89.57％vs 75.20％,P＜0.01).There were no statistical differences between the two groups in terms of serum hs-CRP,IL-6,TNF-α,IL-1β and sTREM-1 levels at 3 d after surgery(P＞0.05).The frontal lobe group exhibited obviously higher levels of serum BDNF and NGF while lower levels of serum S100B and NSE at 1 week after surgery than the temporal lobe group(P＜0.01).At 1 week and 1 month after surgery,the NIHSS scores and the rates of good prognosis were notably higher in the frontal lobe group than the temporal lobe group(P＜0.01).There was no significant difference in incidence of complications between the two groups(5.22％vs 12.00％,P＞0.05).Conclusion Compared with neuroendoscopic hematoma removal via temporal lobe approach,the surgery via frontal lobe approach has more significant clinical efficacy in the treatment of elderly HICH,with the advantages of effectively regulating the levels of neurological function indicators,promoting the recovery of neurological function and improving the prognosis of patients.
Keywords：intracranial hemorrhagehypertensiveneuroendoscopesinflammationhematoma removal
Publication Date：2025-12-15
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：5( 1626-1630 )