Trans-frontal stereotactic puncture and drainage versus craniotomy in the treatment of basal ganglia hemorrhage: a prospective comparative study

Abstract

Objective To assess the effect of stereotactic puncture and drainage compared with craniotomy in the treatment of patients with hypertensive intracerebral hemorrhage (HICH) in basal ganglia region. Methods From March 2013 to September 2014, a prospective controlled study was undertaken at the Department of Neurosurgery, the Third Affiliated Hospital of Soochow University. Sixty-eight patients of basal ganglia hemorrhage without brain hernia were enrolled, among which 24 cases underwent trans-frontal stereotactic puncture and drainage (puncture group), and the remaining 44 cases received craniotomy and hematoma removal (craniotomy group). The parameters, including operation time, postoperative complications, 1-month postoperative mortality and 6-month postoperative activities of daily life (ADL), were compared between the two groups. Results There was no significant difference in age, gender, hematoma location, hematoma volume, state of consciousness or operation timing between the two groups. Compared with that in craniotomy group, the operation time in puncture group was obviously shortened(42.3±11.3 min vs. 172.2±45.3 min, P 0.05)and 1-month postoperative mortality (0% vs. 13.6%, P>0.05). Conclusions Compared with craniotomy, stereotactic puncture and drainage demonstrate the advantages including relative convenience, minimal invasiveness, safety and good outcome. It could be preferred for the non-hernia patients with HICH in basal ganglia region. Craniotomy might be performed for the rebleeding patients after puncturing who need reoperation. Key words: Intracranial hemorrhage, hypertensive; Basal ganglia; Stereotactic puncture and drainage; Craniotomy; Prospective study