BACKGROUND AND PURPOSE: There has been a nonstandard surgical procedure and extensive international controversy in minimally invasive surgery (MIS) for the management of spontaneous supratentorial intracerebral hemorrhage. This meta-analysis assessed the effectiveness of MIS as compared with other treatment options, including conservative medical treatment and conventional craniotomy, in patients with supratentorial intracerebral hemorrhage. METHODS: PubMed, Embase, Cochrane Controlled Trials Register (CCTR), Web of Science, European Association for Grey Literature Exploitation (EAGLE), National Technical Information Service (NTIS), Current Controlled Trials, Clinical Trials, International Clinical Trials Registry, Internet Stroke Center, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI) (last searched December 2011) were searched. Randomized controlled trials on MIS in patients with computed tomography-confirmed supratentorial intracerebral hemorrhage were included. We excluded low-quality randomized controlled trials. The death or dependence at the end of follow-up was defined as the primary outcome, and the death at the end of follow-up was defined as the secondary outcome. RESULTS: The 313 randomized controlled trials met the included criteria. We only analyzed 12 high-quality randomized controlled trials involving 1955 patients. The quality of the included trials was consistently high. OR of the primary outcome and secondary outcome of MIS both showed significant reductions (OR, 0.54, P<0.00001; OR, 0.53, P<0.00001). CONCLUSIONS: Patients with supratentorial intracerebral hemorrhage may benefit more from MIS than other treatment options. The most likely candidates to benefit from MIS are both sexes, age of 30 to 80 years with superficial hematoma, Glasgow Coma Scale score of ≥9, hematoma volume between 25 and 40 mL, and within 72 hours after onset of symptoms. Our study could help select appropriate patients for MIS and guide clinicians to optimize treatment strategies in supratentorial intracerebral hemorrhage.
BACKGROUND AND PURPOSE: There has been a nonstandard surgical procedure and extensive international controversy in minimally invasive surgery (MIS) for the management of spontaneous supratentorial intracerebral hemorrhage. This meta-analysis assessed the effectiveness of MIS as compared with other treatment options, including conservative medical treatment and conventional craniotomy, in patients with supratentorial intracerebral hemorrhage. METHODS: PubMed, Embase, Cochrane Controlled Trials Register (CCTR), Web of Science, European Association for Grey Literature Exploitation (EAGLE), National Technical Information Service (NTIS), Current Controlled Trials, Clinical Trials, International Clinical Trials Registry, Internet Stroke Center, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI) (last searched December 2011) were searched. Randomized controlled trials on MIS in patients with computed tomography-confirmed supratentorial intracerebral hemorrhage were included. We excluded low-quality randomized controlled trials. The death or dependence at the end of follow-up was defined as the primary outcome, and the death at the end of follow-up was defined as the secondary outcome. RESULTS: The 313 randomized controlled trials met the included criteria. We only analyzed 12 high-quality randomized controlled trials involving 1955 patients. The quality of the included trials was consistently high. OR of the primary outcome and secondary outcome of MIS both showed significant reductions (OR, 0.54, P<0.00001; OR, 0.53, P<0.00001). CONCLUSIONS:Patients with supratentorial intracerebral hemorrhage may benefit more from MIS than other treatment options. The most likely candidates to benefit from MIS are both sexes, age of 30 to 80 years with superficial hematoma, Glasgow Coma Scale score of ≥9, hematoma volume between 25 and 40 mL, and within 72 hours after onset of symptoms. Our study could help select appropriate patients for MIS and guide clinicians to optimize treatment strategies in supratentorial intracerebral hemorrhage.
Authors: Ching-Jen Chen; Dale Ding; Natasha Ironside; Thomas J Buell; Andrew M Southerland; Daniel Woo; Bradford B Worrall Journal: World Neurosurg Date: 2019-02-08 Impact factor: 2.104
Authors: Wendy C Ziai; Nichol McBee; Karen Lane; Kennedy R Lees; Jesse Dawson; Paul Vespa; Richard E Thompson; A David Mendelow; Carlos S Kase; J Ricardo Carhuapoma; Carol B Thompson; Steven W Mayo; Pat Reilly; Scott Janis; Craig S Anderson; Mark R Harrigan; Paul J Camarata; Jean-Louis Caron; Mario Zuccarello; Issam A Awad; Daniel F Hanley Journal: Int J Stroke Date: 2019-04-03 Impact factor: 5.266
Authors: Daniel F Hanley; Richard E Thompson; Michael Rosenblum; Gayane Yenokyan; Karen Lane; Nichol McBee; Steven W Mayo; Amanda J Bistran-Hall; Dheeraj Gandhi; W Andrew Mould; Natalie Ullman; Hasan Ali; J Ricardo Carhuapoma; Carlos S Kase; Kennedy R Lees; Jesse Dawson; Alastair Wilson; Joshua F Betz; Elizabeth A Sugar; Yi Hao; Radhika Avadhani; Jean-Louis Caron; Mark R Harrigan; Andrew P Carlson; Diederik Bulters; David LeDoux; Judy Huang; Cully Cobb; Gaurav Gupta; Ryan Kitagawa; Michael R Chicoine; Hiren Patel; Robert Dodd; Paul J Camarata; Stacey Wolfe; Agnieszka Stadnik; P Lynn Money; Patrick Mitchell; Rosario Sarabia; Sagi Harnof; Pal Barzo; Andreas Unterberg; Jeanne S Teitelbaum; Weimin Wang; Craig S Anderson; A David Mendelow; Barbara Gregson; Scott Janis; Paul Vespa; Wendy Ziai; Mario Zuccarello; Issam A Awad Journal: Lancet Date: 2019-02-07 Impact factor: 79.321
Authors: D Andrew Wilkinson; Aditya S Pandey; B Gregory Thompson; Richard F Keep; Ya Hua; Guohua Xi Journal: Neuropharmacology Date: 2017-09-22 Impact factor: 5.250