Abstract
Hemorrhagic stroke accounts for a significant proportion of mortality and confers a poor quality of life with high dependency among survivors. Surgical evacuation of hematoma has the advantage of rapidly controlling the increased intracranial pressure, halting the ongoing herniation syndrome, and mitigating the secondary cascades of events mediated by the inflammatory and blood degradation products. The advantage is hindered by the concurrent insult to the healthy brain tissue while passing through the normal brain tissue. Therefore, minimally invasive approaches to evacuate the hematoma are employed, but the need for an expensive surgical armamentarium and the expert multidisciplinary team is the bottleneck for their application, particularly in low-income nations. We herein performed a study upon the role of mini craniotomy open surgical method of evacuating hematoma in selected patients with supratentorial intracerebral hemorrhage. We found a significant reduction in the surgery length, minimized risk of post-surgery complications, shortened intensive care unit stay, and reduced mortality compared to the full-fledged craniotomy and endoscopy-guided surgery. There is a need for a large-scale randomized multicenter prospective study to verify the advantages of minimally invasive approaches in the management of symptomatic supratentorial intracerebral hemorrhages.
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Conflicts of Interest
The authors declare no conflicts of interest concerning this article.
Ethical Approval
All procedures performed in studies involving human participants were in accord with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Committee of the College of Medical Sciences in Chitwan, Nepal; permit no. 2020-107.
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Written informed consent was obtained from all individual participants included in the study or their guardians.
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Bhattarai, B., Bajracharya, A., Gurung, S., Giri, S., Sah, S.B., Munakomi, S. (2021). Mini Craniotomy in the Management of Supratentorial Spontaneous Intracranial Hemorrhage: A Single-Center Outcome of the Minimally Invasive Treatment. In: Pokorski, M. (eds) Best Practice in Health Care. Advances in Experimental Medicine and Biology(), vol 1335. Springer, Cham. https://doi.org/10.1007/5584_2021_632
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DOI: https://doi.org/10.1007/5584_2021_632
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