A Standardized Approach to Minimally Invasive Treatment of Intracerebral Hemorrhage Based on Multimodal AI and Neuronavigation

DOI: https://doi.org/10.62517/jmhs.202605313

Author(s)

Jiyang Zhuang1, Guanglei Yu1, Rongjun Xie1, Jiaqi Wang1, Haichao Su2,*

Affiliation(s)

1Mudanjiang Medical University, Mudanjiang, Heilongjiang, China 2Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang, China *Corresponding Author

Abstract

Hypertensive intracerebral hemorrhage (HICH) remains a critical cerebrovascular emergency with persistently high incidence, disability, and mortality rates in China, with over one million new cases annually, placing a heavy burden on families and the public healthcare system. Minimally invasive puncture and drainage has become the mainstream surgical approach for HICH across various hospital levels due to its advantages of minimal trauma, convenient operation, and short hospital stay . However, the puncture accuracy and hematoma evacuation efficacy of this procedure heavily depend on the neurosurgeon's radiological interpretation skills and surgical experience. Traditional static neuronavigation relies solely on preoperative single‑phase CT images for trajectory planning. During surgery, hematoma aspiration and brain tissue edema‑induced shifts cause substantial “navigation drift,” with puncture errors reaching 3–5 mm, which can easily damage the corticospinal tract and critical intracranial vessels, leading to severe complications such as rebleeding and profound neurological deficits. Meanwhile, current AI‑assisted research on intracerebral hemorrhage mostly confines itself to single-phase CT imaging, failing to incorporate multimodal sequences like MRI and Diffusion Tensor Imaging (DTI) that clearly delineate white matter fiber tracts and small vascular anatomy, thus posing substantial limitations on preoperative risk assessment and puncture route recommendation. This article systematically reviews the domestic and international research landscape of neuronavigation and multimodal artificial intelligence in the minimally invasive treatment of intracerebral hemorrhage. It categorizes and summarizes the strengths and inherent shortcomings of three technical classes-single‑modality imaging algorithms, static navigation, and multimodal fusion navigation-and identifies core gaps in current clinical standardization efforts. Furthermore, it analyzes future technological iterations and clinical evolution trends in this field, thereby providing a comprehensive theoretical foundation and literature support for our proposed five‑tier integrated standardization research.

Keywords

Hypertensive Intracerebral Hemorrhage; Multimodal Artificial Intelligence; Neuronavigation; Minimally Invasive Puncture; Diagnostic and Therapeutic Standardization; Deep Learning

References

[1] Liu Zhao, Pan Enyu, Che Yanjun. Comparison of the effects of different doses of urokinase combined with minimally invasive hematoma drainage therapy in the treatment of hypertensive cerebral hemorrhage [J]. China Practical Medicine,2026, 21(6):107-110. [2] Huangfu Luo Kai, Liang Chunyang, Mao Jinlong, et al. Research on the application of electromagnetic navigation technology in minimally invasive treatment of spontaneous intracerebral hemorrhage [J]. Journal of Clinical Neurosurgery,2025, 22(5):481-485+491. [3] Liu Yu, Wang Genwei, Li Kai, et al. The effect and prognosis of CT-guided neuroendoscopic minimally invasive surgery in the treatment of hypertensive cerebral hemorrhage [J]. Clinical Medical Engineering, 2025, 32(8):821-824. [4] Zhang Benying, Sha Jichang, Wu Qingjiao. Application of neuroendoscopic minimally invasive surgery under ultrasound guidance in the treatment of hypertensive cerebral hemorrhage [J]. System Medicine,2025, 10(13):145-148. [5] Zhou Dong, Luo Jianli. Clinical study on the use of 3D-slicer-assisted minimally invasive soft channel puncture for the treatment of hypertensive cerebral hemorrhage [J]. Chinese Journal of Practical Neurology,2025, 28(5):620-625. [6] Tang Jun, Xu Wenhao, Li Yuan. Comparison of the effects of CT-based localization techniques combined with minimally invasive hematoma drainage procedures versus traditional craniotomy approaches in the treatment of patients with hypertensive cerebral hemorrhage [J]. Journal of Practical Cardiology, Neurology, Pulmonary and Vascular Diseases,2024, 32(5):123-127. [7] Yuan Chunmiao, Yao Guangwei, Dai Hong, et al. Clinical efficacy of 3D-Slicer software-assisted minimally invasive hematoma removal in the treatment of hypertensive cerebral hemorrhage, along with analysis of factors affecting prognosis [J]. Life Science Instruments,2023, 21(4):79-83. [8] Xu Lu. Clinical application of neuro-navigation-based minimally invasive puncture therapy in the treatment of hypertensive cerebral hemorrhage. Hebei Medical University,2023. [9] Zhao B. Research progress in minimally invasive treatment of hypertensive intracerebral hemorrhage [J]. Medical Theory and Practice,2016, 29(7):864‑866.