title: Minimally invasive stereotactic puncture and thrombolysis therapy improves long-term outcome after acute intracerebral hemorrhage.
abstract: The purpose of this study was to judge the clinical value of minimally invasive stereotactic puncture and thrombolysis therapy (MISPTT) for acute intracerebral hemorrhage (ICH). A randomized control clinical trial was undertaken. According to the enrollment criteria, 122 acute ICH cases were analyzed, of which 64 cases received MISPTT (MISPTT group, MG) and 58 cases received conventional craniotomy (CC group, CG). The Glasgow coma scale (GCS) scores, postoperative complications (PC), and rebleeding incidences were compared. Moreover, 1 year postoperation, the long-term outcomes of patients with regard to hematoma volume (HV) <50 mL and HV ≥50 mL were judged, respectively, by the Glasgow outcome scale (GOS), Barthel index (BI), modified Rankin Scale (mRS), and case fatality (CF). MG patients showed obvious amelioration in GCS score compared with that of CG patients. The total incidence of PC in MG decreased compared with that of CG. The incidences of rebleeding in MG and CG were 9.4 and 17.2%, respectively (P = 0.243). There were no obvious differences between the CFs of MG and CG (17.2 and 25.9%, respectively, P = 0.199). The GOS, BI, and mRS representing long-term outcome for both HV <50 mL and HV ≥50 mL in MG were ameliorated significantly greater than that in CG patients (all P < 0.05). These data suggest that there are advantages with MISPTT not only in trauma and safety, but the MISPTT group had fewer complications and a trend toward improved short-term and long-term outcomes.
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12# Middle WuLuMuQi Rd, Shanghai 200040, China.
authors.forename: Houguang
authors.initials: H
authors.lastname: Zhou
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Huang
authors.forename: Yuping
authors.initials: Y
authors.lastname: Tang
authors.forename: Jingjing
authors.initials: J
authors.lastname: Su
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.forename: Xu
authors.initials: X
authors.lastname: Han
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Xue
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
mesh_terms: D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003399:Craniotomy / Q000379:methods; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods*; D018709:Statistics, Nonparametric; D013238:Stereotaxic Techniques; D020521:Stroke / Q000150:complications; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome