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Updated: Jul 12, 2026
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.
Background:
This study was designed to evaluate the outcomes of patients with Traumatic Brain Injury (TBI) who presented with a supratentorial Intraparenchymal hemorrhage (IPH) volume > 30 cc. We hypothesized that operative intervention would result in better mortality outcome.
Methods:
Trauma Quality Improvement Program (TQIP) database of 2019-2023 was queried for the project. Patients' demographic information and clinical characteristics and injury type and injury severity score (ISS), Glasgow Coma Scale (GCS) score and outcomes were compared between the groups who underwent craniotomy or craniectomy (CR) and the group who received medical management (MM). Propensity score matching was performed and a p value of < 0.05 was considered statistically significant.
Results:
Propensity score matching created 486 pairs of patients. Pair-matched analysis showed no significant differences between the MM and the CR groups regarding age (63 [48-74] vs. 63 [49.3-74],P = 0.815), ISS (median [IQR] 26 [26-30] vs. 26 [26-30], P = 0.47, GCS (median [IQR] 11 [4-14.75] vs. 10 [5 -14], P = 0.668), both reactive pupils (79.8% vs. 82.1%) and significant midline shift (72.2% vs. 72.2 %,). Pair matched analysis showed CR group had significant lower in-hospital mortality (30.9% vs. 38.1%, (odds ratio[95%CI], 0.715 [0.538, 0.948]) ,P = 0.019) when compared to MM group. However, CR patients found to have longer hospital stay and more post operative complications compared to MM group.
Conclusion:
Operative intervention was associated with significant improvement in mortality for a large IPH volume when compared to MM group.
