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

Haixiao Liu1,2, Dongbo Li2,3, Yaning Cai1

  • 1Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.

Neurocritical Care
|February 26, 2025
PubMed
Abstract

Insights

Minimally invasive surgery for spontaneous cerebellar hemorrhage (SCH) has varied outcomes. Advanced age, minimally invasive catheter (MIC) evacuation, and large perihematomal edema (PHE) predict poor long-term prognosis.

Area of Science:

  • Neurosurgery
  • Neurology
  • Medical imaging

Background:

  • Minimally invasive surgery (MIS) is common for spontaneous cerebellar hemorrhage (SCH).
  • Long-term prognosis after MIS for SCH varies significantly.
  • Identifying risk factors for unfavorable outcomes is crucial.

Purpose of the Study:

  • To explore risk factors for unfavorable prognosis in patients with SCH undergoing MIS.
  • To identify predictors of long-term neurological outcome after MIS for SCH.

Main Methods:

  • A case-control study nested within a multicenter cohort.
  • Collected data on medical history, perioperative CT scans, and 6-month prognosis.
  • Compared patients with favorable (mRS ≤ 3) and unfavorable (mRS ≥ 4) outcomes.

Main Results:

  • Eighty patients were analyzed.
  • Advanced age, MIC evacuation, large postoperative PHE, and large preoperative PHE were independent risk factors for unfavorable 6-month outcomes.
  • Preoperative PHE (≥ 10 ml) was a reliable predictor (AUC = 0.849), with 47.4% unfavorable outcomes vs. 2.4% in smaller PHE groups.

Conclusions:

  • Advanced age, MIC evacuation, and PHE (pre- and postoperative) are associated with unfavorable outcomes in SCH patients after MIS.
  • Large preoperative PHE (≥ 10 ml) is a significant independent predictor of unfavorable long-term neurological outcomes.
Keywords:
Neurological outcomePerihematomal edemaResidual hematomaSpontaneous cerebellar hemorrhage

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