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Ibrahim A, Arifianto MR, Al Fauzi A. Minimally Invasive Neuroendoscopic Surgery for Spontaneous Intracerebral Hemorrhage: A Review of the Rationale and Associated Complications. ACTA NEUROCHIRURGICA. SUPPLEMENT 2023; 130:103-108. [PMID: 37548729 DOI: 10.1007/978-3-030-12887-6_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Spontaneous intracerebral hemorrhage (ICH) is associated with a poor prognosis. Its mortality rate exceeds 40%, and 10-15% of survivors remain fully dependent. Considering the limited number of effective therapeutic options in such cases, the possibilities for surgical interventions aimed at removal of a hematoma should always be borne in mind. Although conventional surgery for deep-seated ICH has failed to show an improvement in outcomes, use of minimally invasive techniques-in particular, neuroendoscopic procedures-may be more effective and has demonstrated promising results. Although there are certain risks of morbidities (including rebleeding, epilepsy, meningitis, infection, pneumonia, and digestive tract disorders) and a nonnegligible risk of mortality, their incidence rates after neuroendoscopic evacuation of ICH compare favorably with those after conventional surgery. Prevention of complications requires careful postoperative surveillance of the patient and, preferably, treatment in a neurointensive care unit, as well as early detection and appropriate management of associated comorbidities.
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Affiliation(s)
- Arie Ibrahim
- Department of Neurosurgery, A. Wahab Syahranie Hospital and Faculty of Medicine, Mulawarman University, Kota Samarinda, Kalimantan Timur, Indonesia.
| | - Muhammad Reza Arifianto
- Department of Neurosurgery, Dr. Soetomo General Hospital and Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Asra Al Fauzi
- Department of Neurosurgery, Dr. Soetomo General Hospital and Faculty of Medicine, Airlangga University, Surabaya, Indonesia
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Pan Q, Zhu W, Zhang X, Chang J, Cui J. Research on a bifurcation location algorithm of a drainage tube based on 3D medical images. Vis Comput Ind Biomed Art 2020; 3:2. [PMID: 32240438 PMCID: PMC7099540 DOI: 10.1186/s42492-019-0039-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/04/2019] [Indexed: 12/02/2022] Open
Abstract
Based on patient computerized tomography data, we segmented a region containing an intracranial hematoma using the threshold method and reconstructed the 3D hematoma model. To improve the efficiency and accuracy of identifying puncture points, a point-cloud search arithmetic method for modified adaptive weighted particle swarm optimization is proposed and used for optimal external axis extraction. According to the characteristics of the multitube drainage tube and the clinical needs of puncture for intracranial hematoma removal, the proposed algorithm can provide an optimal route for a drainage tube for the hematoma, the precise position of the puncture point, and preoperative planning information, which have considerable instructional significance for clinicians.
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Affiliation(s)
- Qiuling Pan
- College of Sciences, North China University of Science and Technology, Tangshan 063210, Hebei, China
| | - Wei Zhu
- College of Sciences, North China University of Science and Technology, Tangshan 063210, Hebei, China
| | - Xiaolin Zhang
- College of Sciences, North China University of Science and Technology, Tangshan 063210, Hebei, China
| | - Jincai Chang
- College of Sciences, North China University of Science and Technology, Tangshan 063210, Hebei, China.
| | - Jianzhong Cui
- Department of Neurosurgery, Tangshan Gongren Hospital, Tangshan 063000, Hebei, China.
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Son W, Park J, Kang DH, Han YM, Choi YJ, Ohk B. In-Vitro Study of Urokinase Thrombolysis Following Stereotactic Aspiration of Intracerebral Hematoma. J Korean Neurosurg Soc 2019; 63:380-385. [PMID: 31752479 PMCID: PMC7218200 DOI: 10.3340/jkns.2018.0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/18/2019] [Indexed: 11/27/2022] Open
Abstract
Objective A consensus regarding the ideal regimen for urokinase (UK) thrombolysis subsequent to stereotactic spontaneous intracerebral hemorrhage aspiration has yet to be established. The purpose of this study is to evaluate the efficacy of UK thrombolysis relative to when the regimen is changed.
Methods Venous blood from 30 heathy volunteers was obtained for this in-vitro study. Various concentrations of UK solution were added to microcentrifuge tubes containing the clotted blood. The efficacy of UK thrombolysis was identified by checking the weight of lysed hematoma following various time intervals with different concentrations of UK solution. Group one, the “3×4” group involved four administrations every 3 hours over 12 hours, and group two, the “6×2” group involved two administrations every 6 hours over 12 hours.
Results More hematoma was lysed in the 3×4 group than the 6×2 group across all concentration levels (however, the differences were only significant between groups at the 500 and 1000 IU concentration levels, p<0.05). There were no significant differences of lysed hematoma among the various UK solution concentrations within groups.
Conclusion This study suggests that frequent administrations of UK thrombolysis may result in a greater degree of lysed hematoma in comparison to a higher concentration of UK.
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Affiliation(s)
- Wonsoo Son
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jaechan Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Young-Min Han
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yeon-Ju Choi
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Boram Ohk
- Department of Clinical Trial Center, Kyungpook National University Hospital, Daegu, Korea
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Wu R, Qin H, Cai Z, Shi J, Cao J, Mao Y, Dong B. The Clinical Efficacy of Electromagnetic Navigation-Guided Hematoma Puncture Drainage in Patients with Hypertensive Basal Ganglia Hemorrhage. World Neurosurg 2018; 118:e115-e122. [PMID: 29959072 DOI: 10.1016/j.wneu.2018.06.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/15/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the clinical efficacy of navigation-guided minimally invasive surgery in patients with hypertensive basal ganglia hemorrhage. METHODS A total of 64 patients with hypertensive basal ganglia hemorrhage were enrolled in this retrospective study. They were divided into a navigation group and a traditional group based on surgical approaches. The data for the 2 groups of patients were analyzed with regard for the hematoma clearance rate, duration of surgery, duration of hospitalization, Glasgow Outcome Scale score at discharge, Barthel index score at 6 months, and postoperative complication rates for rebleeding and pneumonia. RESULTS There were no significant differences in basic characteristics between the 2 groups (P > 0.05). The hematoma clearance rate was significantly lower in the navigation group (49.18 ± 16.76%) than in the traditional group (84.29 ± 6.91%, P < 0.01). The duration of surgery and duration of hospitalization were significantly shorter in the navigation group (55.00 ± 11.89 minutes and 24.25 ± 7.1 days, respectively) than in the traditional group (156.38 ± 47.9 minutes and 32.63 ± 9.8 days, respectively; both P < 0.01). There were also significant differences between the 2 groups in Glasgow Outcome Scale scores (P = 0.006). The Barthel index scores were significantly greater in the navigation group (73.13 ± 18.76) than in the traditional group (57.63 ± 26.63, P < 0.05). There were no significant differences between the 2 groups in the complication rates (P > 0.05). CONCLUSIONS Under certain conditions, compared with standard craniotomy and hematoma evacuation, navigation-guided hematoma puncture aspiration and catheter drainage is simple, effective, and safe as a treatment for hypertensive basal ganglia hemorrhage.
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Affiliation(s)
- Ruhong Wu
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Huaping Qin
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Zhonghai Cai
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Jia Shi
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Jiachao Cao
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Yumin Mao
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Bo Dong
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China.
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Xu F, Lian L, Liang Q, Zhu W, Liu X, Kang H, Zhang M, Wang F, Xue Z, Tang Z, Zhu S. Extensive basal ganglia hematomas treated by local thrombolysis versus conservative management – a comparative retrospective analysis. Br J Neurosurg 2016; 30:401-6. [DOI: 10.3109/02688697.2016.1161168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Beynon C, Schiebel P, Bösel J, Unterberg AW, Orakcioglu B. Minimally invasive endoscopic surgery for treatment of spontaneous intracerebral haematomas. Neurosurg Rev 2015; 38:421-8; discussion 428. [DOI: 10.1007/s10143-015-0606-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 11/16/2014] [Indexed: 10/24/2022]
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Dun Z, Zhu S, Jiang H. Benefits of a frame-based stereotactic surgical planning system for the treatment of spontaneous intracerebral haematomas. J Int Med Res 2013; 41:1550-9. [PMID: 24026775 DOI: 10.1177/0300060513498022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Frame-based stereotactic surgical planning systems (SSPSs) have been used for deep brain stimulation and radioneurosurgery. Here, we evaluated the feasibility, safety and efficacy of using a SSPS to aid spontaneous intracerebral haematoma (ICH) treatment. METHODS Patients with moderate spontaneous putamen haematomas were randomized into two groups: treatment (group A) and control (group B). In group B, the catheter for evacuating haematomas was inserted into a target point, located at the centre of the haematoma, using conventional frame-based stereotactics; urokinase thrombolysis was subsequently delivered through the catheter. In group A, this procedure was assisted by a SSPS, which designed both the target point and trajectory in the haematoma through virtual reality. Duration of evacuating haematomas and number of urokinase injections was compared between groups. RESULTS In total, 65 patients were recruited: in group A (n = 30), the duration of evacuating haematomas (35.27 ± 9.17 h) was shorter than in group B (n = 35; 67.77 ± 13.82 h). There were fewer urokinase injections in group A (3.63 ± 1.16) than in group B (6.40 ± 1.29). CONCLUSIONS The feasibility, efficacy and safety of spontaneous ICH treatment were optimized by the use of a frame-based SSPS.
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Affiliation(s)
- Zhiping Dun
- Department of Neurosurgery, The Second Hospital, Shandong University, Jinan, Shandong Province, China
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Beyond therapeutic nihilism? The neurosurgical treatment of intracerebral hemorrhage. World Neurosurg 2012; 80:e135-7. [PMID: 22381877 DOI: 10.1016/j.wneu.2012.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 01/13/2012] [Indexed: 11/21/2022]
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Xu F, Tang Z, Luo X, Kang H, Hu Q, Zhu S. No evidence of preoperative hematoma growth representing an increased postoperative rebleeding risk for minimally invasive aspiration and thrombolysis of ICH. Br J Neurosurg 2010; 24:268-74. [DOI: 10.3109/02688691003624588] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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