No evidence of preoperative hematoma growth representing an increased postoperative rebleeding risk for minimally invasive aspiration and thrombolysis of ICH

Abstract

The minimally invasive aspiration and thrombolysis has emerged as a promising strategy management modifying the neurological outcome of ICH (intracerebral hemorrhage) patients. In the present study, we introduce our experience with minimally invasive aspiration and thrombolysis for ICH and investigate whether the preoperative hematoma growth represents an increased postoperative rebleeding risk. There were 128 ICH patients enrolled in this report. All the ICH patients were diagnosed by the baseline CT scan in the initial 6 hours after ictus. Within the 24 hours after ictus, a second CT scan was performed to estimate whether existed the preoperative hematoma growth. The first aspiration was avoided in the first 6 hours after symptom onset. All the patients were divided into two groups: preoperative hematoma growth group (Group A) and non-preoperative hematoma growth group (Group B). After the hematoma aspiration, subsequent thrombolysis and drainage were performed and CT scans were repeated everyday until the puncture needle and catheter were removed. Forty-nine cases of all the treated patients were demonstrated with preoperative hematoma growth and sixteen cases were identified with postoperative rebleeding. No significant difference was demonstrated in the proportion of single/double needle puncture, hematoma volume of aspiration, drained volume, total dose of urokinase between Group A and B (P = 0.674, 0.212, 0.831 and 0.862, respectively). No significant difference in the incidence of postoperative rebleeding, the mean volume of residual hematoma and GCS score after the aspiration and thrombolysis was detected between the two groups (P = 1.000, 0.894 and 0.969, respectively). As to the mortality in hospital, the significant difference between Group A and B was not identified (P = 0.389). Our date suggests there is no evidence of preoperative hematoma growth representing an increased postoperative rebleeding risk for the minimally invasive aspiration and thrombolysis of spontaneous intracerebral hemorrhage.

Key words:

• Cerebral hemorrhage
• hematoma enlargement
• aspiration
• thrombolysis
• surgical treatment

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.