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Updated: Jul 12, 2026
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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Surgical outcomes in a large traumatic Intraparenchymal hemorrhage
Nasim Ahmed1, Yen-Hong Kuo2, Aasim Kazmi3
1Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, Neptune, NJ, USA; Hackensack Meridian School of Medicine, Nutley, NJ, USA.
Summary
Surgical intervention significantly reduced mortality in patients with large traumatic brain injuries (TBI) and intraparenchymal hemorrhage (IPH). While operative intervention improved survival outcomes for TBI-IPH, it was associated with longer hospital stays and increased complications.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Critical Care Medicine
Background:
- Traumatic Brain Injury (TBI) with large supratentorial Intraparenchymal Hemorrhage (IPH) presents significant management challenges.
- Evaluating the efficacy of operative intervention versus medical management is crucial for improving patient outcomes.
Purpose of the Study:
- To compare mortality outcomes between operative intervention (craniotomy/craniectomy) and medical management for TBI patients with IPH volume > 30 cc.
- To identify factors influencing outcomes in this patient cohort.
Main Methods:
- Utilized the 2019-2023 Trauma Quality Improvement Program (TQIP) database.
- Compared demographic, clinical characteristics, and injury severity between craniotomy/craniectomy (CR) and medical management (MM) groups.
- Employed propensity score matching to control for confounding variables, with p < 0.05 considered significant.
Main Results:
- Propensity score matching yielded 486 patient pairs with no significant baseline differences in age, ISS, GCS, pupil reactivity, or midline shift.
- The CR group demonstrated significantly lower in-hospital mortality (30.9% vs. 38.1%, P=0.019) compared to the MM group.
- However, the CR group experienced longer hospital stays and a higher incidence of postoperative complications.
Conclusions:
- Operative intervention for large IPH volumes in TBI patients is associated with a significant reduction in mortality.
- While surgical management improves survival, careful consideration of increased hospital stay and postoperative complications is warranted.
