Clinical Efficacy and Safety of Neuroendoscopic Surgery for Severe Ventricular Thalamic Hemorrhage

Abstract Objective To summarize and analyze the clinical efficacy and safety of neuroendoscopic surgery in the treatment of patients with severe ventricular thalamic hemorrhage. Methods Eight-three patients with severe ventricular thalamic hemorrhage were treated in the Neurosurgery Department of Anqing Hospital Affiliated to Anhui Medical University from July 2019 to August 2021. Of the 83 patients, 41 underwent neuroendoscopic surgery and 42 underwent simple extraventricular drainage. The hospital stay, GCS scores on the 1st and 14th days postoperatively, the incidence of intracranial infections, and the clearance of postoperative hematomas were compared and analyzed between the two groups. The patients were followed up to 6 months. The prognosis was evaluated by the activity of daily living (ADL) score. A head CT or MRI was obtained to determine whether there was hydrocephalus, cerebral infarction, or other related complications. Results The postoperative hospital stay was 17.42±1.53 days, the GCS score was 6.56±0.21 points on day 1 and 10.83±0.36 points on day 14, intracranial infections occurred in three patients (7.31%) and the hematoma clearance rate was 83.6±5.18% in the neuroendoscopy group, all of which were significantly better than the simple extraventricular drainage group (P < 0.05). After 6 months of follow-up, 28 patients (68.29%) had a good prognosis, 5 patients (12.19%) died, and 4 patients(9.75%)had hydrocephalus in the neuroendoscopy group. In the extraventricular drainage group, the prognosis was good in 15 patients (35.71%), death in 12 patients (28.57%), and hydrocephalus in 17 patients (40.47%). The follow-up results showed that the good prognosis, mortality, and incidence of hydrocephalus in the neuroendoscopy group were significantly better than the extraventricular drainage group (P < 0.05). Conclusion Compared with traditional ventricular-puncture drainage, simultaneous endoscopic sinus surgery for severe ventricular thalamic hemorrhage had a higher hematoma clearance rate, fewer intracranial infections, and hydrocephalus, which together improve the clinical prognosis, and is thus recommended for clinical use.