Prognostic Significance of Preoperative Perihematomal Edema in Spontaneous Cerebellar Hemorrhage After Minimally Invasive Surgery

作者：Haixiao Liu, Dongbo Li, Yaning Cai, Longlong Zheng, Zhijun Tan, Feng Liu, Fei Gao, Hui Zhang, Yong Du, Gaoyang Zhou, Feifei Sun, Ruixi Fan, Ping Wang, Lei Wang, Shunnan Ge, Tianzhi Zhao, Tao Zhang, Rongjun Zhang, Guoqiang Xie, Yan Qu, Wei Guo · 发表于：Research Square · 年份：2022 · DOI：10.21203/rs.3.rs-2249349/v1 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Neurosurgical Procedures and Complications、Spinal Hematomas and Complications

Abstract Background Minimally invasive surgery (MIS), including endoscopic evacuation and minimally invasive catheter (MIC) evacuation, has been widely used in spontaneous cerebellar hemorrhage (SCH) patients. However, the long-term prognosis varies widely. Herein, we aimed to explore the prognostic risk factors of neurological outcome, including peri-operative hematoma and perihematomal edema (PHE), in SCH patients after MIS. Methods Eighty consecutive SCH patients, who underwent MIS between July 2019 and Nov. 2021 from 4 neurosurgical centers were enrolled prospectively. Patients were dichotomized into good (modified Rankin Scale (mRS) score ≤ 3) and poor neurological outcome (mRS score ≥ 4) groups. Peri-operative CT scans were assessed by two independent raters. Hematoma and PHE volume were calculated using 3D Slicer software. Predictors of poor neurological outcome were assessed in logistic regression models. Results Among the enrolled patients, 44 underwent endoscopic evacuation and 36 underwent MIC evacuation. The overall poor neurological outcome rate was 23.8%. Older patients, underwent MIC evacuation, large postoperative PHE, and large preoperative PHE (OR = 1.57, 95% CI: 1.20–1.90) were independently associated with poor neurological outcome. According to the restricted cubic splines analysis, patients were divided into large preoperative PHE subgroup (PHE ≥ 10 ml) and small preoperative PHE subgroup (PHE < 10 ml). In small preoperative PHE subgroup, 1 patient (2...