The intracranial pressure change in hypertensive cerebral hemorrhage patients treated with drilling and craniotomy drainage,and its correlation with postoperative cognitive dysfunction

Objective:To investigate the intracranial pressure changes in hypertensive cerebral hemorrhage patients treated with drilling and craniotomy drainage,and its correlation with postoperative cognitive dysfunction.Methods:One hundred and six patients with hypertensive cerebral hemorrhage were randomly divided into the craniotomy group and drilling group using the random number table method(53 cases each group).The craniotomy group and drilling group were treated with traditional craniotomy drainage and minimally invasive drilling drainage,respectively.The postoperative neurologic deficit and cognitive function recovery after 1h,12h,24h,72h and 1w of operation between two groups were compared.Results:The intracranial pressure after 1h,12h,24h,72h and 1w of operation in drilling group were significantly higher than those in craniotomy group(P<0.01).After 6 months of operation,the NIHSS score in drilling group was lower than that in craniotomy group(P<0.01),and the NIHSS scores of two groups were significantly lower than that before operation(P<0.01).After 1 month of operation,the levels of NSE and BDNF in drilling group were lower than those in craniotomy group(P<0.01),the levels of NSE and BDNF in two groups after 1 month of operation were significantly lower and higher than those after 3d of operation,respectively(P<0.01).After 6 months of operation,the cognitive dysfunction in two groups were improved compared before operation(P<0.01).The distribution of MMSE score in drilling group was better than that in craniotomy group(P<0.01),The rate of cognitive impairment in drilling group was significantly lower than that in craniotomy group(P<0.05).Conclusions:In the treatment of hypertensive cerebral hemorrhage,the craniotomy drainage has advantage in reducing intracranial pressure,and the drilling drainage has advantage in improving nerve function and cognitive function.