ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
This article is part of the Research TopicExternal Ventricular Drainage in Neurological and Neurosurgical Practice: Current Trends, Challenges, and Future DirectionsView all 3 articles
Clinical Study on Minimally Invasive Drilling and Drainage Combined with Intracranial Pressure Monitoring for Hypertensive Intracerebral Hemorrhage
Provisionally accepted
- 1Vall d'Hebron Institut de Recerca, Barcelona, Spain
- 2Department of Neurosurgery, First Affiliated Hospital of Jilin University, Changchun, China
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Objective: Elevated intracranial pressure (ICP) aggravates symptoms and increases mortality in intracerebral hemorrhage. This study evaluates the guiding value of dynamic ICP monitoring in the treatment of hypertensive intracerebral hemorrhage using minimally invasive drilling and drainage. Methods: A retrospective analysis was conducted on 190 patients with hypertensive intracerebral hemorrhage in the basal ganglia region who underwent minimally invasive drilling and drainage. They were divided into an ICP monitoring group (90 cases) and a non-monitoring group (100 cases) based on whether an ICP probe was placed intraoperatively. Clinical variables including 3-month modified Rankin Scale (mRS) score postoperatively, hematoma and surgical variables, postoperative management, Glasgow Coma Scale (GCS) score, and complications were recorded. Statistical analysis was performed using SPSS. Univariate and multivariate analyses were conducted to assess the impact of ICP monitoring on prognosis and related risk factors. Results: Compared to the non-monitoring group, the ICP monitoring group had significantly lower mannitol usage (P=0.036), fewer postoperative CT scans (P<0.001), and a lower incidence of renal insufficiency (P=0.019). At discharge, the ICP monitoring group showed higher GCS scores (P< 0.001). At 3 months post-operation, mRS scores were significantly better in the ICP monitoring group (P=0.025), especially in patients aged 41-65 (P=0.005). Multivariate analysis identified hematoma volume(P=0.006), hemorrhage side(P=0.032), and intraventricular extension(P=0.005) as independent risk factors affecting 3-month postoperative outcomes. Conclusion: Minimally invasive drilling and drainage combined with ICP monitoring is a safe and effective treatment for hypertensive intracerebral hemorrhage in the basal ganglia. Reducing CT scans, mannitol usage, and the risk of renal insufficiency, while improving discharge GCS scores and 3-month postoperative outcomes. Hemorrhage side, hematoma volume, and intraventricular extension were identified as independent prognostic factors.
Keywords: functional outcome, Hypertensive intracerebral hemorrhage, Intracranial Pressure, Intracranial pressure monitoring, Mass effect, Minimally Invasive Drilling and Drainage, Perihematomal edema
Received: 28 Aug 2025; Accepted: 02 Jan 2026.
Copyright: © 2026 Chen, Cheng and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bin Qi
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