caa a22 4500 463179250 CHVBK 20180406164834.0 cr unu---uuuuu 170326e20070601xx s 000 0 eng 10.1007/s00381-007-0325-6 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0325-6 Endoscopy-guided removal of spontaneous intracerebral hemorrhage: comparison with computer tomography-guided stereotactic evacuation [Elektronische Daten] [Tetsuhiro Nishihara, Akio Morita, Akira Teraoka, Takaaki Kirino] Background and purpose: Spontaneous intracerebral hemorrhage (ICH) continues to be a major medical and socioeconomic problem. While the surgical procedure failed to show benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. The authors introduced endoscopy-guided evacuation in managing ICH and reports the benefits over the conventional method. Materials and methods: Twenty-seven cases underwent endoscopic evacuation of ICH (Group E). The clinical features and outcomes were compared to the retrospective data of 20 cases who underwent computer tomography (CT)-guided stereotactic removal of ICH (Group C). Confidence level less than 0.05 was considered statistically significant. Results: While the clinical features of the two groups were not significantly different except for the ICH volume, outcomes were better in all aspects in Group E. The patients in Group E required shorter operative time (72min vs 102min, p < 0.01) with better hematoma evacuation (95.5% vs 75%, p < 0.01), shorter stay in the intensive care unit (ICU; 4.2days vs 6.9days, p < 0.01) and less frequent CT scanning (6.4 times vs 8.6 times, p < 0.01) compared to the patients in Group C. Neurological outcome improved significantly in Group E 1week after surgery (p < 0.01), but not in Group C. Glasgow outcome scale at 6months were better in Group E than in Group C (p < 0.05). Nine patients (33%) showed good recovery at 6months postoperatively after endoscopic evacuation of ICH. Conclusion: Endoscopic hematoma evacuation provided the quick, adequate decompression of ICH. The outcomes were better than the CT-guided hematoma removal. Further study is necessary to evaluate the real benefit of this surgical procedure over the functional outcome of ICH. Springer-Verlag, 2007 Endoscopy nationallicence Intracerebral hemorrhage nationallicence Surgical treatment nationallicence Stereotactic surgery nationallicence Nishihara Tetsuhiro Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut Morita Akio Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut Teraoka Akira Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut Kirino Takaaki Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut Child's Nervous System Springer-Verlag 23/6(2007-06-01), 677-683 0256-7040 23:6<677 2007 23 381 https://doi.org/10.1007/s00381-007-0325-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0325-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nishihara Tetsuhiro Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Morita Akio Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Teraoka Akira Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Kirino Takaaki Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/6(2007-06-01), 677-683 0256-7040 23:6<677 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer