A prospective controlled study: minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage

Abstract

Abstract Background Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with the high mortality twofold to sixfold higher than that for ischemic stroke. But the treatment of haematomas within the basal ganglia continues to be a matter of debate among neurologists and neurosurgeons. The purpose of this study is to judge the short-term and long-term clinical value of minimally invasive stereotactic puncture therapy (MISPT) on acute ICH. Methods A prospective controlled study was undertaken. The clinical trial was in compliance with the WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. According to the enrollment criterion, there were 168 acute ICH cases analyzed, of which 90 cases were performed by MISPT (MISPT group, MG) and 78 cases by Conventional craniotomy (CC group, CG), by means of compare of short-term outcome such as Glasgow Coma Scale (GCS) score, postoperative complications (PC) and rebleeding incidence (RI), moreover, long-term outcome of 1 year postoperation judged by Glasgow Outcome Scale (GOS), Barthel Index (BI), modified Rankin Scale (mRS) and case fatality (CF). Results GCS score of MG patients showed obvious amelioration when compared with that of CG (P = 0.039). The PC incidence of in MG decreased obviously compared with that of CG (P = 0.000). The incidences of rebleeding in MG and CG were 10.0% and 15.4% respectively (P = 0.293). There was no obvious difference between CFs of MG and CG. For three parameters representing long-term outcome,the GOS, BI and mRS in MG were ameliorated significantly than that of CG (P = 0.043, P = 0.011 and P = 0.042 respectively). Conclusion These data indicated that compared with CC, the advantage of MISPT was not only displayed in short-term outcome such as minute trauma and safety, but also seemed to be feasible and had a trend towards improved long-term outcome such as the GOS,BI and mRS. Trial Registration The Australian New Zealand Clinical Trials Registry (ANZCTR), the registration number:ACTRN12610000945022.