Different techniques of minimally invasive craniopuncture for the treatment of hypertensive intracerebral hemorrhage

Department of Neurology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, No.6 Beijing West Road, Huaiyin District, Huai'an, Jiangsu, 223300, China. Department of Neurology, The Second People's Hospital of Huai'an, No.62 Huaihai South Road, Qingpu District, Huai'an, Jiangsu 223300, China. Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Gusu District, Suzhou, Jiangsu, 215004, China. Electronic address: ctwub7@163.com.

World neurosurgery. 2019

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OBJECTIVE Efficacy of minimally invasive craniopuncture with the YL-1 puncture needle (hard-channel) and soft drainage tube (soft-channel) in treating hypertensive intracerebral hemorrhage (HICH). MATERIALS AND METHODS Totally 150 HICH patients were randomly assigned into three groups, conservative group (n=50), hard-channel group (n=50) and soft-channel group (n=50). Computed tomography, National Institutes of Health Stroke Scale (NIHSS) and levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and in drainage fluid were examined on day2, 4, 6 post operation. RESULTS Compared with conservative group, serum levels of IL-6, TNF-alpha and MDA were decreased and SOD was increased (p<0.05); volumes of hematoma and peri-hematomal edema as well as NIHSS were reduced (p<0.05) in minimally invasive groups on day7, 14, 28 post operation. Compared with the hard-channel group, serum levels of IL-6, TNF-alpha, MDA and SOD appeared the same trend as above in the soft-channel group. In the soft-channel group, MDA was reduced and SOD was increased in brain drainage fluid on day2, 4, 6 (p<0.05); volumes of hematoma and peri-hematomal edema on day14, 28 appeared reduction compared with the hard-channel group (p<0.05). There was no significant difference of volumes of hematoma and peri-hematomal edema on day7 between minimally invasive groups. NIHSS of the soft-channel group appeared a significant reduction on day7, 14, 28 post operation (p<0.05). CONCLUSION Soft-channel minimally invasive craniopuncture is an ideal technique for treating HICH, with advantages of alleviating cerebral edema, reducing oxidative stress and inhibiting inflammatory response.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine