Clinical effect of neuroendoscopic hematoma removal via anterior middle frontal gyrus approach in the treatment of non-cerebral hernia basal ganglia hemorrhage and its influence on postoperative edema volume around hematoma
WANG Haosheng
SHEN Zhe
CHEN Haoyang
WANG Yaoqi
GU Long
NING Zhaohui
FENG Yang
Abstract：Objective To explore the clinical effect of neuroendoscopic hematoma removal via anterior middle frontal gyrus approach in the treatment of non-cerebral hernia basal ganglia hemorrhage and its influence on the postoperative edema volume around hematoma.Methods A total of 82 patients with non-cerebral hernia basal ganglia hemorrhage admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to January 2025 were selected.According to different surgical methods,42 patients who underwent neuroendoscopic hematoma removal via anterior middle frontal gyrus approach were included in the neuroendoscopic group,and 40 patients who underwent microscopic craniotomy and hematoma removal via temporal lobe cortex approach were included in the microscopic craniotomy group.The surgery-related indicators(intraoperative blood loss volume,surgical time,hemostasis time,postoperative hospitalization time)and clinical efficacy(hematoma removal rate,total effective rate),hematoma volume and edema volume around hematoma before surgery and on the 5th day after surgery,occurrence of postoperative complications and prognosis-related indicators[modified Rankin scale(mRS)score and National Institutes of Health stroke scale(NIHSS)score at 6 months after surgery]were compared between the two groups.Results Compared with the microscopic craniotomy group,the neuroendoscopic group had less intraoperative blood loss volume,shorter surgical time,hemostasis time and postoperative hospitalization time as well as a significantly higher total effective rate of hematoma removal(P<0.05).The hematoma volume of patients in both groups was significantly reduced on the 5th day after surgery compared to that before surgery,and the volume in the neuroendoscopic group was significantly less than that in the microscopic craniotomy group(P<0.05).The edema volume around hematoma was significantly increased in the two groups compared to that before surgery,and the edema volume in the neuroendoscopic group was obviously less than that in the microscopic craniotomy group(P<0.05).The total incidence rate of postoperative complications was significantly lower in the neuroendoscopic group(11.90%)than that in the microscopic craniotomy group(32.50%)(P<0.05).At 6 months after surgery,the mRS score and NIHSS score in the neuroendoscopic group were significantly lower than those in the microscopic craniotomy group(P<0.05).Conclusions Neuroendoscopic hematoma removal via anterior middle frontal gyrus approach has the advantages of shorter surgical time,lesser intraoperative blood loss and faster hemostasis in the treatment of non-cerebral hernia basal ganglia hemorrhage.It can effectively remove the hematoma,and has small edema around hematoma,low risk of postoperative complications and good prognosis,thus this procedure is worthy of clinical promotion and application.
Keywords：neuroendoscopyanterior middle frontal gyrus approachhematoma removalnon-cerebral hernia basal ganglia hemorrhagepostoperative edema volume around hematomaclinical effect
Publication Date：2026-03-28
Online Publishing Date：2026-03-26(First online date of this platform, not the publication date of the document)
Pages：6( 70-75 )