To compare the therapeutic effects between ultra-early microsurgery through the cerebral sulcus fissure and the cerebral gyrus cortex approach for the treatment of basal ganglia hemorrhage.

A retrospective analysis was conducted on 122 patients with basal ganglia hemorrhage treated at Neurosurgery Department of the Second Affiliated Hospital of Xi'an Medical University from January 2021 to December 2022. All patients underwent surgery within 7 h after the onset of symptoms and were divided into two groups based on the surgical approach: 68 cases in the cerebral sulcus fissure group and 54 cases in the cerebral gyrus cortex group. The study compared the surgical-related indicators, complication rates, serum 5-hydroxytryptamine (5-HT) and norepinephrine (NE) levels before and 7 d after surgery, National Institutes of Health stroke scale (NIHSS) scores and scandinavian stroke scale (SSS) scores before and 30 d after surgery, as well as the prognosis 30 d post-surgery between the two groups.

There were no statistically significant differences between the two groups in terms of surgery duration, hematoma clearance rate, intraoperative blood loss, hospital stay, and re-bleeding rates (P>0.05). At 7 d post-surgery, both groups showed a significant increase in serum 5-HT and NE levels compared to pre-surgery, with higher levels observed in the cerebral sulcus fissure group than in the cerebral gyrus cortex group, with statistical significance (P<0.05). At 30 d post-surgery, both groups had significantly lower NIHSS scores and higher SSS scores compared to pre-surgery, with the cerebral sulcus fissure group showing lower NIHSS scores and higher SSS scores than the cerebral gyrus cortex group, with statistical significance (P<0.05). The favorable prognosis rate of the cerebral sulcus fissure group (94.12%) was higher than that of the cerebral gyrus cortex group (66.66%), with statistical significance (P<0.05).

The efficacy of ultra-early microsurgery through the cerebral sulcus fissure for the treatment of basal ganglia hemorrhage is superior to that of microsurgery through the cerebral gyrus cortex, which can reduce the inhibition of 5-HT and NE, and help the recovery of neurological function.