Liao Changpin, Ni Zepeng, Lu Zhen, Liang Jiancheng, Nong Shengde, Ye Jing, Wei Xianfu
Department of Neurosurgery, Baise People's Hospital, Guangxi, China.
Department of Neurosurgery, Maoming People's Hospital, Guangdong, China.
Front Neurol. 2025 Apr 25;16:1522598. doi: 10.3389/fneur.2025.1522598. eCollection 2025.
To examine the efficacy of the CTA angiographic point sign in forecasting secondary hematoma expansion following stereotactic surgery in patients with moderate-volume basilar ganglia hematoma and it's potential to enhance postoperative outcomes.
A retrospective analysis was conducted on the clinical data of 143 patients with moderate-volume basal ganglia hematoma (hematoma volume between 30 mL and 60 mL) admitted to the Department of Neurosurgery at Baise People's Hospital from January 2021 to December 2022. Stereotactic surgery guided by the CTA angiographic point sign was conducted in 79 patients (experimental group), while stereotactic surgery guided by the computed tomography (CT) scan was performed in 64 patients (control group). The short-term clinical results (incidence of secondary hematoma expansion, Glasgow Coma Scale (GCS) score within 30 days, death, surgical complications) and long-term clinical outcomes [Modified Rankin Scale (MRS) score after 6 months] were analysed by comparing the two groups.
No subsequent hematoma expansion occurrences transpired in the experimental group post-surgery, but 12 (18.75%) such events were observed in the control group following the procedure. The experimental group experienced 27 postoperative lung infections (34.18%), whereas the control group had 33 infections (51.56%). The average GCS score was (9.46 ± 2.23) in the experimental group and (7.94 ± 4.68) in the control group. The mortality rate was 2 (2.53%) in the experimental group and 8 (12.50%) in the control group. The treatment efficacy rate (MRS) at 6 months was 59 cases (74.68%) in the experimental group and 35 cases (54.69%) in the control group. The disparity between the two groups was statistically significant ( < 0.05).
CTA angiographic point-guided stereotactic surgery can significantly diminish the incidence of subsequent hematoma expansion following the procedure, enhancing patient clinical outcomes and postoperative quality of life.
探讨CTA血管造影术点征在预测中等体积基底节区血肿患者立体定向手术后继发性血肿扩大中的疗效及其改善术后结局的潜力。
回顾性分析2021年1月至2022年12月百色市人民医院神经外科收治的143例中等体积基底节区血肿（血肿体积30～60 mL）患者的临床资料。79例患者（实验组）采用CTA血管造影术点征引导下的立体定向手术，64例患者（对照组）采用计算机断层扫描（CT）引导下的立体定向手术。通过比较两组分析短期临床结果（继发性血肿扩大发生率、30天内格拉斯哥昏迷量表（GCS）评分、死亡、手术并发症）和长期临床结局[6个月后改良Rankin量表（MRS）评分]。
实验组术后未发生继发性血肿扩大，而对照组术后观察到12例（18.75%）此类事件。实验组术后发生肺部感染27例（34.18%），对照组发生33例（51.56%）。实验组平均GCS评分为（9.46±2.23），对照组为（7.94±4.68）。实验组死亡率为2例（2.53%），对照组为8例（12.50%）。实验组6个月时治疗有效率（MRS）为59例（74.68%），对照组为35例（54.69%）。两组间差异有统计学意义（<0.05）。
CTA血管造影术点征引导下的立体定向手术可显著降低术后继发性血肿扩大的发生率，改善患者临床结局和术后生活质量。
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