Pneumocephalus following the minimally invasive hematoma aspiration and thrombolysis for ICH

Abstract

Introduction. The objective of this study was to clarify whether pneumocephalus occurred and affected the outcome following minimally invasive hematoma aspiration and thrombolysis for intracerebral hemorrhage (ICH). Materials and methods. A prospective case note review on all ICH patients treated with the micro-invasive procedure presenting to our division from 2006 to 2011 was conducted. Demographic, clinical, and outcome data were documented; head CT scans were applied postoperatively to identify the intracranial air collection. The ICH victims with pneumocephalus were included into Group A and the others into Group B. A multi-variant analysis was performed between Groups A and B to examine the effect of pneumocephalus on the prognosis. Results. Data were collected on a total of 134 cases in this study, among whom 72.38% developed pneumocephalus postoperatively. No significant difference was demonstrated in terms of the preoperative and postoperative hematoma volume, Glasgow Coma Scale (GCS) score, middle line shift (MLS), and 30-day mortality rate between Groups A and B, respectively. Moreover, the long-term outcome rated by GCS of these two groups was also similar. Logistic regression analysis indicated double-needle puncture be an independent risk factor for both postoperative pneumocephalus (OR, 2.478; 95% CI, 1.010–6.080; P = 0.045) and its degree (OR, 11.84; 95%CI, 4.141–30.208; P < 0.001). Conclusion: The present study shows that pneumocephalus is common following the minimally invasive hematoma aspiration and thrombolysis for ICH but may not affect the outcome. And double-needle puncture may be the risk factor for pneumocephalus.

Keywords::

• aspiration
• cerebral hemorrhage
• complication
• pneumocephalus
• thrombolysis
• surgical treatment

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