Outcomes, neurological function, and inflammation indices following minimally invasive hematoma removal in hypertensive cerebral hemorrhage patients.

Abstract

Objective: To evaluate the clinical efficacy of minimally invasive removal of intracranial hematoma (MIRICH) in the treatment of patients with hypertensive intracranial hemorrhage (HICH) and its effect on brain nerve function and body inflammation index.

Methods: This retrospective study involved 150 HICH patients treated at Shanghai Blue Cross Brain Hospital from January 2019 to March 2024. Patients were assigned into two groups according to the surgical approach they received: the control group (n = 75), treated with traditional craniotomy, and the observation group (n = 75), treated with MIRICH. The two groups were compared in terms of operative parameters, hematoma clearance rate, clinical efficacy, neurological function recovery, inflammatory markers, and postoperative complications. Risk factors affecting clinical efficacy were also analyzed.

Results: Compared to the control group, the observation group had significantly shorter operation and hospitalization times, less intraoperative blood loss, and a higher hematoma clearance rate (P < 0.05). The total effective rate was significantly higher in observation group than that in control group (94.67% vs. 84.00%; χ² = 4.478, P = 0.034). Three months after operation, compared to the control group, the neurological deficit score and NIH Stroke Assessment Scale (NIHSS) scale score were significantly lower in the observation group. The Activity of Daily Living Scale (ADL) scale score was significantly higher in the observation group. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the observation group (P < 0.05). The mean velocity (Vm), peak systolic velocity (PSV) and pulsatility index (PI) in the observation group were significantly higher (P < 0.05). The cognitive function score of observation group was significantly higher than that of control group (24.65±3.13 vs. 18.43±2.76; t = 12.919, P < 0.05). The incidence of postoperative complications was 12.00% in the observation group and 17.33% in the control group, with no significant difference (P > 0.05). Multivariate Logistic regression analysis identified age, surgical method, and operation time as significant risk factors affecting clinical efficacy.

Conclusion: MIRICH surgery can improve the hematoma clearance rate in HICH patients, with better clinical efficacy, and less trauma. Additionally, it promotes neurological function recovery, improves the prognosis and living ability of patients, and reduces the level of serum inflammatory factors. It is a promising treatment option worthy of wider adoption.