A Comparative Study of Neuroendoscopic Treatment Versus Craniotomy for Spontaneous Intracerebral Hemorrhage

This study aimed to explore the safety and effectiveness of neuroendoscopy-assisted keyhole craniotomy in treating spontaneous intracerebral hemorrhage.

Fifty-three patients with hypertensive intracerebral hemorrhage who required surgery were recruited. Twenty-four underwent endoscopic hematoma evacuation through a small bone window, and 29 underwent craniotomy. Postoperatively, GCS score improvement, surgical time, midline shift measurement, and intraoperative blood loss were recorded and analyzed.

The endoscopic group's average time from incision to closure was 121±7.67 minutes, compared with 253±10.49 minutes in the craniotomy group ( P <0.01). The endoscopic group's average total blood loss was 45.49±11.90 mL versus 275.00±64.08 ml in the craniotomy group ( P <0.01). No postoperative hemorrhage occurred. Midline shift measurement on postoperative day 1 was 5.73±2.18 mm in the endoscopic group and 7.43±1.51 mm in the craniotomy group, a statistically significant difference ( P <0.01). At 1-month follow-up, midline measurements were normal in both groups. CT showed minimal residual hematoma, with an average evacuation rate of 100% in both groups. The average improvement in postoperative day 1 GCS score was 1.95±2.12 in the endoscopic group and 1.83±0.84 in the craniotomy group.

In treating spontaneous intracerebral hemorrhage, neuroendoscopic minimally invasive surgery is a safe and effective alternative to traditional craniotomy.