DIỄN BIẾN RỐI LOẠN Ý THỨC, HÌNH ẢNH CẮT LỚP VI TÍNH SỌ NÃO Ở NGƯỜI BỆNH CHẢY MÁU NÃO NGUYÊN PHÁT TRÊN LỀU ĐƯỢC ĐIỀU TRỊ PHẪU THUẬT NỘI SOI CÓ ĐỊNH VỊ THẦN KINH HỖ TRỢ

Abstract

Objectives: To describe the evolution of consciousness disturbance and brain computed tomography (CT) imaging changes in patients with supratentorial spontaneous intracerebral hemorrhage treated with neuronavigation-assisted neuroendoscopy evacuation. Methods: A prospective, descriptive, uncontrolled study was conducted on 51 patients with supratentorial spontaneous intracerebral hemorrhage who underwent neuronavigation-assisted neuroendoscopic evacuation at Military Hospital 103 from August 2023 to May 2026. Variables included Glasgow Coma Scale (GCS) over time, hematoma volume, and midline shift on CT. Statistical analyses included repeated measures ANOVA, Friedman test, Wilcoxon signed-rank test, and Spearman correlation analysis. Results: GCS scores changed significantly over time (p < 0.001), decreasing preoperatively and gradually improving postoperatively. Hematoma volume and midline shift increased before surgery but decreased significantly after intervention (p < 0.001). Preoperative GCS score was negatively correlated with hematoma volume (r = -0.292) and midline shift (r = -0.503). Discharge GCS was negatively correlated with postoperative midline shift (r = -0.500; p < 0.001). Conclusion: Consciousness disturbance and brain CT imaging parameters changed significantly during treatment. Imaging indices, particularly midline shift, are valuable in the assessment and prognosis of patients with supratentorial spontaneous intracerebral hemorrhage.