AUTHOR=Liu Haixiao , Wu Xun , Tan Zhijun , Guo Hao , Bai Hao , Wang Bodong , Cui Wenxing , Zheng Longlong , Sun Feifei , Zhang Xiaoyang , Fan Ruixi , Wang Ping , Jing Wenting , Gao Junmei , Guo Wei , Qu Yan 

TITLE=Long-Term Effect of Endoscopic Evacuation for Large Basal Ganglia Hemorrhage With GCS Scores ≦ 8

JOURNAL=Frontiers in Neurology

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00848

DOI=10.3389/fneur.2020.00848

ISSN=1664-2295

ABSTRACT=Aims: The surgical evacuation, including stereotactic aspiration, endoscopic evacuation, and craniotomy, is the most effective way to reduce the volume of intracerebral hemorrhage. However, credible evidence for the effects of these techniques is still insufficient. The present study explored the long-term outcomes of these techniques in the treatment of basal ganglia hematoma with low Glasgow Coma Scale (GCS) scores (≤ 8) and large-volume (≥ 40 ml), which were predictors of high mortality. 
Methods: 258 consecutive patients were reviewed retrospectively. The primary and secondary outcomes were 6-month mortality and 6-month modified Rankin Scale score, which were assessed by a multivariate logistic regression model.
Results: Compared with the endoscopic evacuation group, the mortality was significantly higher in the stereotactic aspiration group (OR 6.858, 95% CI 3.146-14.953) and open craniotomy group (OR 3.315, 95% CI 1.497-7.341). Age (OR=2.237, 95% CI 1.290-3.877) and herniation (OR=2.257, 95% CI 1.172-4.348) were independent predictors for mortality. No significant difference in the neurological functional outcome was found in the stereotactic aspiration group (OR 0.501, 95% CI 0.192-1.308) and the craniotomy group (OR 0.774, 95% CI 0.257-2.335) compared with the endoscopic evacuation group.
Conclusion: Endoscopic evacuation significantly decreased the 6-month mortality in patients with hemorrhage ≥ 40 ml and GCS ≤ 8.