Treatment of intracranial hemorrhage with neuroendoscopy guided by body surface projection

BACKGROUND: We aimed to study the feasibility of body surface projection in neuroendoscopic treatment of intracranial hemorrhage (ICH), and to evaluate the prognosis of muscle strength using diffusion tensor imaging (DTI) technique. METHODS: We utilized 3D-SLICER software and adopted hematoma body surface projection orientation to eliminate ICH by using neuroendoscope for 69 cases of spontaneous intracerebral hemorrhage. The standard of correct location was determined by the direct view of hematoma at the first operation. Evacuation rate by comparing computed tomography (CT) before and after the surgery and Glasgow coma scale (GCS) was computed. DTI was used for pyramidal tract imaging 3 weeks after the operation, while the prognosis of muscle strength was assessed after 6 months. The control group included 69 patients with basal ganglia hemorrhage who received conservative treatment during the same period. RESULTS: The hematoma evacuation rate was 90.75% in average. The average GCS score rose by 4 points one week after the surgery. The shape of pyramidal tract affected the prognosis of body muscle strength, and the simple disruption type was the worst. There was no difference in mortality between the surgery group (10.1%) and the conservative group (4.3%). The muscle strength improvement value and modulate RANK score (MRS) in the surgery group were better than the control group. CONCLUSION: It is convenient and feasible to use the surface projection to determine the target of operation, and the clearance rate of hematoma is high. Pyramidal tract imaging can predict the prognosis of muscle strength.