Comparison of the clinical efficacy of craniotomy and craniopuncture therapy for the early stage of moderate volume spontaneous intracerebral haemorrhage in basal ganglia: Using the CTA spot sign as an entry criterion

Ge, Chunyan; Zhao, Wangmiao; Guo, Hong; Sun, Zhaosheng; Zhang, Wanzeng; Li, Xiaowei; Yang, Xuehui; Zhang, Jinrong; Wang, Dong‐Xin; Xiang, Yang; Mao, Jianhui; Zhang, Wenchao; Guo, Hao; Zhang, Yazhao; Chen, Jianchao

doi:10.1016/j.clineuro.2018.04.002

Cited by 18 publications

(15 citation statements)

References 27 publications

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“…otomy have shown improved outcomes with a less invasive approach, raising the possibility that open craniotomy may damage more brain tissue while removing blood. Both small RCTs 389,398,399,411,412,414 and all meta-analyses of either clinical trials alone or combined with observational studies from different settings comparing stereotactic puncture or endoscopic drainage with craniotomy have shown significantly decreased odds of functional dependence (or combined with death) and increased odds of good functional outcome with MIS. 383,[385][386][387]389,390,394,395 A network meta-analysis suggested the highest ranking of favorable prognosis for stereotactic aspiration, followed by endoscopy, then craniotomy, and last standard medical care.…”

Section: Studies Comparing Mis With Conventional Crani-mentioning

confidence: 99%

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

679

472

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other entities (RWI) can be found at https://professional. heart.org/-/media/phd-files/guidelines-and-statements/ policies-devolopment/aha-asa-disclosure-rwi-policy-5118. pdf?la=en.Beginning in 2017, numerous modifications to AHA/ ASA guidelines have been implemented to make guidelines shorter and enhance user-friendliness. Guidelines are written and presented in a modular knowledge chunk format; each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text, and, when appropriate, flow diagrams or additional tables. Hyperlinked references are provided to facilitate quick access and review. Other modifications to the guidelines include the addition of Knowledge Gaps and Future Research segments in some sections and a web guideline supplement (Online Data Supplement) for useful but noncritical tables and figures.

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Section: Studies Comparing Mis With Conventional Crani-mentioning

confidence: 99%

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

679

472

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show abstract

“…A total of 14 539 reports were screened after eliminating duplicates, of which 14 244 were removed because of irrelevant titles and abstracts. The number of full text articles evaluated according to the prespecified eligibility criteria was 295, and 20 were included in the NMA after quality assessment 13 14 23–40Figure 1. shows the detailed selection process.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 20 included RCTs, three24 33 34 were excluded because of their use of continuous data rather than counting data for neurological scores. The remaining 17 eligible studies comprising 3235 patients reported the incidence of good functional outcome at the end of follow-up (see online supplementary table S1).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of four interventions for spontaneous supratentorial intracerebral hemorrhage: a network meta-analysis

Guo

Pan

Guo

et al. 2020

J NeuroIntervent Surg

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ObjectTo investigate the efficacy and safety of four interventions of spontaneous intracerebral hemorrhage simultaneously.MethodsPubMed, EmBase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) investigating endoscopic surgery (ES), minimally invasive puncture surgery (MIPS), conventional craniotomy (CC), and/or conservative medical treatment (CMT). Good functional outcome, death, and hemorrhage recurrence rates were evaluated by a network meta-analysis.Results20 RCTs with 3603 patients were included. Compared with CMT, a higher rate of good functional outcome was found after ES (RR=2.21, 95% CI 1.37 to 3.55) and MIPS (RR=1.47, 95% CI 1.24 to 1.73). Both ES (RR=0.62, 95% CI 0.44 to 0.86) and MIPS (RR=0.72, 95% CI 0.58 to 0.90) markedly reduced the rate of death. However, there was no significant difference in efficacy and safety between ES and MIPS. The top ranked P score for the efficacy outcome was for ES (P score=0.9810). ES (P-score=0.0709) ranked lowest for the primary safety outcome. There was a higher risk of hemorrhage recurrence after CC (RR=3.80, 95% CI 1.90 to 7.63) and MIPS (RR=2.86, 95% CI 1.70 to 4.82) compared with CMT whereas no significant difference was found for ES (RR=1.46, 95% CI 0.53 to 4.02).ConclusionsThe results suggest that both ES and MIPS significantly improve neurological function and reduce the risk of death compared with CMT, and there is no significant difference between ES and MIPS. Ranking of P scores revealed that ES may be the most optimal intervention to improve functional outcome and prevent death. This needs to be evaluated further.

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“…Intriguingly, it was found that craniopuncture had worse rebleeding rates (40% vs. 19%) and functional outcomes compared to craniotomy in the presence of the spot sign on CT. However, for patients without the spot sign, craniopuncture was equally efficacious as craniotomy had similar a rebleeding rate (12% vs. 17%) [37]. However, there have been no clinical trials for craniopuncture in the US or Europe and thus craniopuncture is not commonly used in these regions.…”

Section: Craniopuncturementioning

confidence: 99%

Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques: A Review

Hannah¹,

Kellner²,

Kellner³

2021

Diagnostics

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Intracerebral hemorrhage (ICH) continues to have high morbidity and mortality. Improving ICH outcomes likely requires rapid removal of blood from the parenchyma and restraining edema formation while also limiting further neuronal damage due to the surgical intervention. Minimally invasive surgery (MIS) approaches promise to provide these benefits and have become alluring options for management of ICH. This review describes six MIS techniques for ICH evacuation including craniopuncture, stereotactic aspiration with thrombolysis, endoport-mediated evacuation, endoscope-assisted evacuation, adjunctive aspiration devices, and the surgiscope. The efficacy of each modality is discussed based on current literature. The largest clinical trials have yet to demonstrate definitive effects of MIS intervention on mortality and functional outcomes for ICH. Thus, there is a significant need for further innovation for ICH treatment. Multiple ongoing trials promise to better clarify the potential of the newer, non-thrombolytic MIS techniques.

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Comparison of the clinical efficacy of craniotomy and craniopuncture therapy for the early stage of moderate volume spontaneous intracerebral haemorrhage in basal ganglia: Using the CTA spot sign as an entry criterion

Cited by 18 publications

References 27 publications

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Efficacy and safety of four interventions for spontaneous supratentorial intracerebral hemorrhage: a network meta-analysis

Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques: A Review

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