Treatment Of Spontaneous Intracerebral Hemorrhage In Patients With Coagulopathy By Cuboid Stereotactic Catheter Indwelt Hematoma Aspiration And The Strategies To Reverse Coagulation Dysfunction

Spontaneous intracerebral hemorrhage is the most common type of hemorrhagic stroke.It is characterized by high morbidity,high disability,and high mortality.The main reason is hypertension,which is known as hypertensive cerebral hemorrhage.Surgical treatment of intracerebral hemorrhage underwent a minimally invasive development from large bone flap surgery to microscopy assisted small bone flap surgery and neuro-endoscopic surgery.There is no surgical condition in the primary hospital,which results in the operation mode of intracerebral hematoma puncture drainage.In order to increase the accuracy of the puncture,the method of stereotactic aid,neural-navigation assisted puncture and other methods have achieved good results.But these technologies require expensive ancillary equipment.Professor Shu-jie Sun,a Chinese scholar,has established a method for the treatment of patients with cerebral hemorrhage by cuboid stereotactic catheter indwelt hematoma aspiration and works well.This method has special surgical instruments.The treatment of patients with cerebral hemorrhage can be operated on the bedside table,which can achieve the effect of small trauma,low cost and easy to learn.It is suitable for the promotion and use in the primary hospital.However,with the development of population aging,the incidence of cardiovascular and cerebrovascular diseases is very high.Anticoagulants,antiplatelet agents,thrombolytic agents,and some new oral anticoagulants are used in many ways,and these antithrombotic drugs work by influencing the mechanism of human coagulation.The incidence of intracranial hemorrhage is high,when the drug overdose,or when combined with hypertension or other triggers.These patients with coagulopathy were associated with increased risk of hematoma enlargement,increased surgical difficulty,and increased incidence of postoperative bleeding.Many scholars at home and abroad have done a lot of research on this problem.They found two ways to increase the success rate.First,the probability of traumatic coagulation can be reduced by minimally invasive surgery.Second,it can reduce the difficulty of surgery by correcting the coagulation functionof these patients.The mechanism of action of each class of drugs is different,and the strategies to reverse the coagulation function are different.The authors also treated many patients with cerebral hemorrhage with coagulation dysfunction and achieved good results.In this article,we will introduce three cases.The first case was spontaneous intracerebral hemorrhage in patient with cirrhosis.In the second case,spontaneous intracerebral hemorrhage occurred in patient with long-term oral aspirin.In the last case,patient with glioma suffered traumatic coagulation after tumor resection,and a large epidural hematoma occurred.All three patients underwent minimally invasive treatment by cuboid stereotactic catheter indwelt hematoma aspiration and the effect was very good.We introduce the technique of cuboid stereotactic catheter indwelt hematoma aspiration in the application of combined coagulation dysfunction in patients with cerebral hemorrhage,and review the strategies to reverse coagulation dysfunction through this three cases and the pertinent literature briefly.