title: Minimally Invasive Surgery for Evacuating the Intracerebral Hematoma in Early Stages Decreased Secondary Damages to the Internal Capsule in Dog Model of ICH Observed by Diffusion Tensor Imaging.
abstract: BACKGROUND
  Diffusion tensor imaging was used to observe the effects of performing early minimally invasive surgery (MIS) on internal capsule in dog model of intracerebral hemorrhage (ICH).
  
  
  METHODS
  Twenty-five male dogs were selected to prepare an ICH model, and then they were randomly distributed into a model control (MC) group (5 dogs) or an MIS group (20 dogs). In the MIS group, the intracerebral hematoma was evacuated by stereotactic minimally invasive procedures over 6 hours (5 dogs), 12 hours (5 dogs), 18 hours (5 dogs), or 24 hours (5 dogs) after successful induction of ICH. The same procedure was performed in the MC group but without evacuating the hematoma. All the animals were sacrificed within 2 weeks after the hematoma was surgically evacuated. The neurologic deficit score and diffusion tensor imaging (DTI) were observed before and after the MIS. The perihematomal blood-brain barrier (BBB) permeability and the brain water content (BWC) were measured 2 weeks after the hematoma was surgically evacuated.
  
  
  RESULTS
  The DTI demonstrated that integrity of the internal capsule restored largely after surgery and the fractional anisotropy (FA) values of the internal capsule on the hematoma side increased significantly as compared with those in the MC group or those before surgery in the same group. The postoperative ratios of FA values of each MIS subgroup increased compared with the MC group and those before surgery in the same subgroup before operation. The neurologic deficit score, the perihematomal BBB permeability, and the BWC of each MIS subgroup decreased significantly compared with those of the MC group. The 6-12-hour group displayed a more favorable result.
  
  
  CONCLUSIONS
  Performing the MIS in the early stage (6-12 hours) after ICH could decrease the secondary damages to the internal capsule so as to promote the recovery of motor function. The optimal time window for MIS should be within 6-12 hours after onset of ICH.
authors.affiliation: Emergency Department, Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC. Electronic address: wuguofeng3013@sina.com.
authors.forename: Guofeng
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Neurology, Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC.
authors.forename: Fan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Emergency Department, Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC.
authors.forename: Likun
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurology, Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC.
authors.forename: Jing
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Radiology of Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC.
authors.forename: Hui
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Radiology of Affiliated Hospital, Guiyang Medical College, Guiyang City, Guizhou Province, PRC.
authors.forename: Yingjun
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000818:Animals; D016880:Anisotropy; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D056324:Diffusion Tensor Imaging; D004195:Disease Models, Animal; D004285:Dogs; D007091:Image Processing, Computer-Assisted; D020772:Internal Capsule / Q000000981:diagnostic imaging* / Q000502:physiology / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009422:Nervous System Diseases / Q000209:etiology; D013997:Time Factors
keywords: Intracerebral hemorrhage; blood-brain barrier; diffusion tensor imaging; dog model of ICH; minimally invasive procedures; neurological deficit score