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Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages.
Med Sci Monit. 2019 Dec 28; 25:10095-10104.MS

Abstract

<strong>

BACKGROUND

</strong> This case series study evaluated the outcome and effect of portable 3D-head computed tomography (CT, MCT-I, 16 rows mobile CT made in China) navigation-guided key-hole microsurgery for supratentorial hypertensive hematomas. <strong>MATERIAL AND

METHODS

</strong> Thirty-five consecutive unconscious patients with a significant volume of hypertensive intracranial hemorrhages (HICH) were treated with 3D image-guided key-hole microsurgery, and the clinical features were summarized. Preoperative and postoperative hematoma volumes and reduction in midline shifts were calculated and recorded. The preoperative and postoperative (initial, discharge, and 180th day after stroke onset) neurological status was assessed by Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS), and modified Rankin Scale (mRS) score, respectively. <strong>

RESULTS

</strong> The range of hematoma volumes of surgical patients was 24-99 ml (median, 50 ml). The median time of CT scan (from the time of the request to navigation finish) was 11 min. Total and near-total (>90%) hematoma evacuation was achieved in 96.9% cases. Compared with the initial state of neurological assessment, there was a significant improvement in MRS and GCS at discharge (P<0.001). After 6 months, 57.1% of patients had achieved functional recovery (GOS 4-5) and 2 patients had died. <strong>

CONCLUSIONS

</strong> As a minimally invasive technique, image-guided transcortical sulci or transsylvian approach is highly effective for immediate and complete hematoma evacuation.

Authors+Show Affiliations

Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China (mainland). Bayi Brain Hospital, The 7th Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China (mainland). Bayi Brain Hospital, The 7th Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China (mainland). Bayi Brain Hospital, The 7th Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31907343

Citation

Zhang, Hong-Tian, et al. "Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 25, 2019, pp. 10095-10104.
Zhang HT, Chen LH, Xu RX. Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages. Med Sci Monit. 2019;25:10095-10104.
Zhang, H. T., Chen, L. H., & Xu, R. X. (2019). Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 25, 10095-10104. https://doi.org/10.12659/MSM.918815
Zhang HT, Chen LH, Xu RX. Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages. Med Sci Monit. 2019 Dec 28;25:10095-10104. PubMed PMID: 31907343.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages. AU - Zhang,Hong-Tian, AU - Chen,Li-Hua, AU - Xu,Ru-Xiang, Y1 - 2019/12/28/ PY - 2020/1/8/entrez PY - 2020/1/8/pubmed PY - 2020/1/8/medline SP - 10095 EP - 10104 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med. Sci. Monit. VL - 25 N2 - <strong>BACKGROUND</strong> This case series study evaluated the outcome and effect of portable 3D-head computed tomography (CT, MCT-I, 16 rows mobile CT made in China) navigation-guided key-hole microsurgery for supratentorial hypertensive hematomas. <strong>MATERIAL AND METHODS</strong> Thirty-five consecutive unconscious patients with a significant volume of hypertensive intracranial hemorrhages (HICH) were treated with 3D image-guided key-hole microsurgery, and the clinical features were summarized. Preoperative and postoperative hematoma volumes and reduction in midline shifts were calculated and recorded. The preoperative and postoperative (initial, discharge, and 180th day after stroke onset) neurological status was assessed by Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS), and modified Rankin Scale (mRS) score, respectively. <strong>RESULTS</strong> The range of hematoma volumes of surgical patients was 24-99 ml (median, 50 ml). The median time of CT scan (from the time of the request to navigation finish) was 11 min. Total and near-total (>90%) hematoma evacuation was achieved in 96.9% cases. Compared with the initial state of neurological assessment, there was a significant improvement in MRS and GCS at discharge (P<0.001). After 6 months, 57.1% of patients had achieved functional recovery (GOS 4-5) and 2 patients had died. <strong>CONCLUSIONS</strong> As a minimally invasive technique, image-guided transcortical sulci or transsylvian approach is highly effective for immediate and complete hematoma evacuation. SN - 1643-3750 UR - https://www.unboundmedicine.com/medline/citation/31907343/Portable_3D-Head_Computed_Tomography_(CT)_Navigation-Guided_Key-Hole_Microsurgery_for_Spontaneous_Hypertensive_Hemorrhages L2 - https://www.medscimonit.com/download/index/idArt/918815 DB - PRIME DP - Unbound Medicine ER -
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