Comparison of endoscopic evacuation, stereotactic aspiration, and craniotomy for treatment of basal ganglia hemorrhage

Background The main surgical techniques for spontaneous basal gangliahemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. Objective To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal gangliahemorrhage. Methods Five hundred and sixteen patients with spontaneous basal gangliahemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomywere reviewed retrospectively. Six-month mortality and the modified Rankin Scalescore were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. Results For the entire cohort, the 6-month mortality in the endoscopic aspirationgroup was significantly lower than that in the stereotactic aspirationgroup (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspirationgroup was lower than that in the craniotomygroup, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysiswas stratified by hematoma volume. The mortality in the endoscopic aspirationgroup was significantly lower than in the stereotactic aspirationgroup in the medium (≥40– Conclusion Endoscopic aspirationcan decrease the 6-month mortality of spontaneous basal gangliahemorrhage, especially in patients with a hematoma volume ≥40 mL.