Analysis of the curative effect and influencing factors of stereotactic aspiration in the treatment of primary brainstem haemorrhage.

Primary brainstem haemorrhage (PBH) is characterized by acute onset, rapid deterioration, many complications, and poor prognosis. Its treatment has been controversial. This study aimed to explore the clinical risk factors of postoperative survival and neurological function recovery of stereotactic aspiration in the treatment of PBH. The clinical data of 65 patients with severe brainstem haemorrhage from February 2019 to February 2020 in the First Hospital of Hebei Medical University were reviewed. All patients were treated with stereotactic haematoma aspiration. We determined the survival status of patients at 30 days after the operation and the recovery of neurological function at 90 days. The modified Rankin Scale score (mRS) was used to assess the survival status. The 30-day mortality rate was 23.1% (15 patients). The proportion of patients with good neurological recovery at 90 days after the operation was 32.3% (21 patients). According to the multivariate logistic regression analysis, the haematoma classification was an independent risk factor for postoperative survival (OR = 0.197, 95% CI: 0.016-0.385, p = 0.046) and recovery of neurological function 90 days after surgery (OR = 0.019, 95% CI: 0.001-0.267, p = 0.003). The haematoma classification is an independent risk factor for 30-day mortality and recovery of neurological function 90 days after surgery. Massive and basal-tegmental haematomas were associated with higher mortality. The prognosis of patients with unilateral and bilateral tegmental haematoma was better than that of patients with other haematoma types.

The Prognosis Factors for Endovascular Coiling of Aneurysm in Patients With Ruptured Intracranial Aneurysm.

BACKGROUND: The spontaneous subarachnoid hemorrhage caused by aneurysm rupture often leads to a variety of complications. Endovascular coiling is effective in the treatment of ruptured intracranial aneurysm. AIM: The authors aim to evaluate the risk factors affecting the prognosis of ruptured intracranial aneurysm in patients who received endovascular coiling treatment successfully. METHODS: The demographic and clinical data including age, gender, blood pressure, blood glucose, Hunt-Hess grade, and Fisher grade at admission, Glasgow outcome scale 3 months after coiling, and the location, size of the aneurysms, coiling methods, and time of intervention were retrospectively reviewed and analyzed. Multivariate analysis and logistic regression were used for data analysis. RESULTS: The history of diabetes mellitus, Hunt-Hess grade, Fisher classification at admission, timing of intervention, as well as the location and size of the aneurysm were prognostic factors for endovascular coiling therapy in patients with ruptured intracranial aneurysm. CONCLUSION: The Fisher scores, Hunt-Hess classification, history of diabetes mellitus, timing of the intervention, as well as the location and size of aneurysm were independent risk factors for ruptured intracranial aneurysms in patients who received endovascular coiling treatment successfully, which could highly affect the outcome of coiling therapy.