Stereotactic puncture surgery combined with early hyperbaric oxygen therapy may be better for long-term functional recovery in patients with moderate amounts of thalamic-inner capsule region haemorrhage

Shiqiang Yang; Yanwei Liu; Shiqiang Wang; Hua Peng; Feilong Yang; Xuhui Hui; Anqiang Yang

doi:10.1016/j.clineuro.2024.108287

Stereotactic puncture surgery combined with early hyperbaric oxygen therapy may be better for long-term functional recovery in patients with moderate amounts of thalamic-inner capsule region haemorrhage

Clin Neurol Neurosurg. 2024 Apr 24:241:108287. doi: 10.1016/j.clineuro.2024.108287. Online ahead of print.

Authors

Shiqiang Yang¹, Yanwei Liu², Shiqiang Wang³, Hua Peng², Feilong Yang⁴, Xuhui Hui⁵, Anqiang Yang⁶

Affiliations

¹ Department of Neurosurgery, First People's Hospital of Yibin, Yibin, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² Department of Neurosurgery, First People's Hospital of Yibin, Yibin, Sichuan, China.
³ Department of Neuro-Oncology, Cancer Hospital, Chongqing University, Chongqing, China.
⁴ Department of Neurosurgery, the Affiliated Santai Hospital of North Sichuan Medical College Mianyang, Sichuan, China.
⁵ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: huixuhui0806@126.com.
⁶ Department of Neurosurgery, First People's Hospital of Yibin, Yibin, Sichuan, China. Electronic address: 717289270@qq.com.

PMID: 38677050
DOI: 10.1016/j.clineuro.2024.108287

Abstract

Background: The prognosis of patients with thalamic hemorrhage is poor, and their long-term neurological impairment is heavy, which seriously affects their work and life.To comparatively analyse the efficacy and prognosis of patients with moderate hemorrhage in the thalamic region who underwent conservative treatment, stereotactic puncture surgery and neuroendoscopic surgery.

Method: This study retrospectively analyzed hospitalization data from 139 adult patients with moderate-volume cerebral hemorrhage in the thalamo-endocapsular region. They were categorized into a stereotactic group (39cases), a neuroendoscopic group (36cases), and a conventional conservative group (64cases). Logistic regression analysis was used to assess risk factors for severe neurological deficits in patients. Multivariate regression modeling was used to compare the correlation of severe neurological deficits among the three groups of patients.

Results: Patients with thalamic moderate-volume cerebral hemorrhage had statistically significantly higher Assessment of Daily Living (ADL) scores in the stereotactic surgery group than in the conservative treatment group and the neuroendoscopic surgery group after 6 months of treatment (p< 0.001).The amount of residual hematoma was significantly lower in the surgery groups than in the conservative treatment group at 3 days, 7 days, and 2 weeks after the onset of the disease (P< 0.001).In multivariate logistic regression analyses, after adjusting for all covariates, the odds ratios for severe neurologic dysfunction in the stereotactic group and the neuroendoscopy group were, respectively, OR: 0.37 (0.12-0.87), P< 0.001 and 0.42 (0.23-1.13), P=0.361).

Conclusion: In patients with moderate volume cerebral hemorrhage in the thalamus-inner capsule region cerebral hemorrhage, patients treated with stereotactic surgery combined with early hyperbaric oxygen therapy may have better long-term neurological recovery compared with conservative and neuroendoscopic surgical treatments.

Keywords: Assessment of Daily Living; Hyperbaric oxygen therapy; Neuroendoscopic surgery; Stereotactic puncture and drainage; Thalamus-internal capsule region hemorrhage.