Minimally invasive surgery for primary supratentorial intracerebral haemorrhage

Ramanan, Mahesh and Shankar, Aparna (2013) Minimally invasive surgery for primary supratentorial intracerebral haemorrhage. Journal of Clinical Neuroscience, 20 12: 1650-1658. doi:10.1016/j.jocn.2013.03.022


Author Ramanan, Mahesh
Shankar, Aparna
Title Minimally invasive surgery for primary supratentorial intracerebral haemorrhage
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 0967-5868
1532-2653
Publication date 2013-12-31
Sub-type Article (original research)
DOI 10.1016/j.jocn.2013.03.022
Open Access Status Not yet assessed
Volume 20
Issue 12
Start page 1650
End page 1658
Total pages 9
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Abstract The use of minimally invasive surgery (MIS) in the treatment of primary supratentorial intracerebral haemorrhage (ICH) is controversial. This review was undertaken to combine all available evidence on this topic and to assess the efficacy of MIS compared to medical treatment or haematoma evacuation via craniotomy for patients with primary supratentorial ICH. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases were searched for randomised controlled trials which compared MIS to any control treatment for intracerebral haemorrhage. Conference proceedings, reference lists and internet-based clinical trial registries were searched for additional studies. Quality was assessed using the Cochrane “risk of bias” analysis tool. The methodological quality of studies was not high, with only two studies conforming to all quality standards assessed. There were 11 studies with 1717 patients. There was a significant reduction in relative risk (RR) for death at end of follow-up when MIS was compared to both medical management (RR = 0.67, 95% confidence interval 0.53–0.84) and craniotomy (RR = 0.57, 95% confidence interval 0.39–0.84) with no significant heterogeneity. Non-significant benefits were observed for the outcomes death or dependent survival (RR = 0.95, 95% confidence interval 0.91–1.00) and independent survival (RR = 1.24, 95% confidence interval 0.99–1.55). There was significant heterogeneity for both these outcomes. MIS for primary supratentorial ICH is associated with a significant reduction in the RR of death when compared to medical management and craniotomy. Other important outcomes need further evaluation.
Keyword Cerebral haemorrhage
Meta-analysis
Minimally invasive surgical procedures
Neuroendoscopy
Stereotaxic techniques
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Thu, 09 Mar 2017, 11:50:08 EST by Mahesh Ramanan on behalf of PAH-Southside Clinical Unit