The Effect Of Surgical Intervention To Brain Edema Development After Hypertensive Intracerebral Hemorrhage

Objective To investigate the effect of Surgical intervention on brain edema formation and development after Hypertensive Intracerebral Hemorrhage (HICH).Methods 160 patients with HICH were divided into conservative group(C group) and surgery group which includes craniotomy group(Sc group) and minimally invasive group(Sm group) . We evaluated the association between baseline hematoma and edema by simple linear regression model. For the conservative group, age, sex, SBP, DBP, GCS, Fib,baseline hematoma, location and blood glucose were independent variable, while the relative growth of perihematomal edema volume(RE) at different time points were dependent variable, all the independent variables were evaluated by simple linear regression except location and multiple linear regression model, respectively; Analysis of variance were used with different bleeding sites, the different classifications of the hematoma volume, surgical and non-surgical, surgery in different ways, different parts of the operation was on the relative growth of perihematomal edema volume. Results There was a highly significant correlation between hematoma an d perihematomal edema volumes at baseline( R2 =0.5831) ,and between hematoma and RE at different time(P<0.01); there was no significant statistic difference between RE of different bleeding sites(P>0.05).A small quantity of supratentorial intracerebral hematoma impact largest on RE(P<0.05); There was no significant difference between RE of Sc group and Sm group, but they were significantly lower as compared with C group(P<0.05).There was no significantly difference between RE of C group and Sc group with infratentorial intracerebral Hemorrhage (P>0.05).Conclusions The degree of perihematomal edema and RE are strongly related to the size of the baseline hematoma of HICH; A small quantity of supratentorial hematoma impacts largely on the development of brain edema; Removing hematoma by surgery can reduce the development of brain edema.