Objective To retrospectively analyze the effect of combined preventive measures on the incidence and prognosis of post-traumatic cerebral infarction (PTCI) in adults. Methods All the adult patients admitted with moderate or severe head injury since the May 2003 were treated by comprehensive preventive methods such as using less hemostatics, ensuring cerebral perfusion, taking surgical procedure timely to relieve cerebral herniation, scavenging the blood clots in subarachnoid space, improving cerebral circulation, et al. Comparative analysis was conducted on the incidence and prognosis of PTCI occurred in patients with moderate or severe head injury between 1999-2007 in our department. All the patients were divided into two groups: traditional group (1999-2003) and preventive group (2003-2007). Results PTCI occurred in 29 cases of traditional group and the incidence rate was 6.90%. 7 cases died. In the 15 follow-up cases: 4 in vegetative state, 5 severe neurological deficit, 4 moderate neurological deficit, and 2 good recovery. PTCI occurred in 17 cases of preventive group and the incidence rate was 3.02%. 2 cases died. In the 14 follow-up cases: 1 in vegetative state, 4 severe neurological deficit, 3 moderate neurological deficit, and 6 good recovery. Statistical analysis showed significant difference in both the incidence rate and the long-term prognosis of PTCI between the two groups. Conclusion The occurrence of PTCI have multi-influential factors and often results in worse consequence. Taking preventive measures at the very beginning after head injury will help reduce the incidence of PTCI and improve the prognosis.

Objective:To evaluate the clinical efficacy and safety of neuro-endoscopic evacuation and microsurgery via keyhole approach in early spontaneous supertentorial intracerebral hemorrhage (ICH). Methods:A prospective multi-center randomized controlled trial was performed; 114 patients with spontaneous supertentorial ICH (time from onset to surgery<6 h) admitted to Departments of Neurosurgery, Shunde Hospital of Southern Medical University, Jiangmen Central Hospital, Affiliated Hospital of School of Medicine of Yanbian University from January 2019 to December 2021 and met the surgical indications were selected. They were divided into endoscopic group (evacuation of intracerebral hematoma under neuroendoscope, n=71) and microscopic group (microsurgery of intracerebral hematoma via keyhole approach, n=43) according to different surgical methods. After 1:1 propensity score matching of the general data, surgical time, hematoma clearance rate, early postoperative re-bleeding rate, Glasgow coma scale (GCS) scores 7 d after surgery, activity of daily living (ADL) scores 6 months after surgery, mortality, and surgery-related complications of 66 patients (33 from each group after matching) were compared. Results:The difference of surgical time between endoscopic group and microscopic group was statistically significant (125[102, 157] mins vs. 175[125, 260] mins, P<0.05). However, hematoma clearance rate (93.00%[80.88%, 96.52%] vs. 93.31%[88.15%, 96.03%]), early postoperative re-bleeding rate (15.2% vs. 9.1%), GCS scores 7 d after surgery (13[10, 15] vs. 12[8, 14]), ADL scores 6 months after surgery (65[45, 85] vs. 55[0, 85]), mortality rate (18.2% vs. 21.2%) and incidences of postoperative intracranial infection and acquired pulmonary infection were not statistically significant between the two groups ( P>0.05). Conclusion:Comparing with microsurgery via keyhole approach, neuro-endoscopy could shorten the surgical time, but not improve the prognosis or safety in early spontaneous supertentorial ICH patients.