Abstract:

Objective

To investigate the clinical efficacy of 3D printing-assisted neuroendoscopic surgery in treating supratentorial hypertensive intracerebral hemorrhage (HICH) with intraventricular extension.

Methods

A retrospective analysis was performed on 50 patients with supratentorial HICH and intraventricular hemorrhage admitted to the Department of Neurosurgery, Suzhou Municipal Hospital from October 2020 to April 2023.Patients were divided into a control group [(25 cases, treated with traditional microscopic surgery + external ventricular drainage (EVD)] and an observation group(25 cases, treated with 3D printing-assisted neuroendoscopic surgery + EVD).Demographic and clinical parameters were compared between groups, including age, sex, hematoma volume, Glasgow coma scale(GCS) score, preoperative muscle strength of the affected limb, operative time, bone window area, EVD duration, hospitalization duration, hematoma clearance rates (intraparenchymal and intraventricular),rebleeding episodes, intracranial/pulmonary infection cases, modified Rankin scale (mRS) scores at 3-month follow-up, and postoperative muscle strength at 3 months in patients with preoperative mild/moderate compression of the posterior limb of the internal capsule.

Results

No significant differences were observed between groups in age, sex, hematoma volume, GCS score, or preoperative muscle strength (P＞0.05).The observation group showed significantly shorter operative time, smaller bone window area, shorter EVD duration, and reduced hospitalization time compared to the control group(P＜0.05).While intraparenchymal hematoma clearance rates were comparable (P＞0.05), the observation group achieved significantly higher intraventricular hematoma clearance rates (P＜0.05).Rates of rebleeding,intracranial infection, and pulmonary infection were lower in the observation group, though without statistical significance (P＞0.05).No intergroup significant difference was found in 3-month mRS scores (P＞0.05); however, patients with preoperative mild/moderate posterior limb compression in the observation group exhibited significantly improved postoperative muscle strength at 3 months (P＜0.05).

Conclusion

3D printing-assisted neuroendoscopic minimally invasive surgery effectively clears both intraparenchymal and intraventricular hematomas, offering advantages of minimal trauma, shorter operative time, and reduced hospitalization.It represents a promising therapeutic modality for hypertensive intracerebral hemorrhage.

Key words: Hypertensive intracerebral hemorrhage, Intraventricular hemorrhage, Neuroendoscopy, 3D-Slicer, 3D printing