Research ReportMinimally invasive procedures for intracerebral hematoma evacuation in early stages decrease perihematomal glutamate level and improve neurological function in a rabbit model of ICH

Introduction: To observe the effects of performing a minimally invasive procedure at different stages after intracerebral hemorrhage (ICH) on perihematomal glutamate level and neurological function. Methods: Forty-eight rabbits were randomly placed into a model control group (MC group, 24 rabbits) or a minimally invasive group (MI group, 24 rabbits). An ICH model was established in all of the animals. In the MI group, the ICH was evacuated by minimally invasive procedures in 6 h (6 rabbits), 12 h (6 rabbits), 18 h (6 rabbits) and 24 h (6 rabbits) after the ICH model was successfully induced. All of the animals were sacrificed within 48 h after the hematoma was evacuated by surgery. A neurological deficit score was determined, and the perihematomal glutamate level and the BBB permeability were measured. Results: The neurological deficit score, perihematomal glutamate level and BBB permeability of the MI group were decreased significantly compared with the MC group. Performing the minimally invasive procedures in 6-12  h after ICH showed the most significant decreases of the glutamate level, BBB permeability and neurological deficit score. Conclusions: The optimal time window of performing the minimally invasive procedures for the intracerebral hematoma evacuation might be within 6-12  h after hemorrhage.

► This manuscript observed the pathophysiological time window of a minimally invasive surgery for ICH. ► The perihematomal glutamate level increased after the ICH was induced, also the BBB permeability. ► The perihematomal glutamate level decreased after the hematoma was evacuated. ► The perihematomal BBB permeability and the neurofunctional score also decreased after the hematoma was evacuated. ► Performing the minimally invasive surgery in 6-12  h after ICH displayed a remarkable outcome.