Introduction
Methods and materials
Study design
Patient management
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Availability of intraoperative CT or CBCT imaging.
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Supratentorial location without vascular pathology (excluded by computerized tomography angiography (CTA) and/or digital subtraction angiography (DSA)).
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Hematoma volume 20–90 ml.
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Reduced level of consciousness with a Glasgow Coma Scale (GCS) score 5–14.
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Premorbid modified Rankin Scale (mRS) score ≤ 1.
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Stable control CT after 6 h without spot sign and surgery ideally within 72 h.
Statistical analysis
Results
Patient characteristics and surgery
No. | Age, sex | Hemisphere | Location | ICH score | OAC / PI | OAC / PI reversal | Time to surgery (hrs) | Surgery duration (min) | PreOP GCS | PostOP GCS | 30-day mortality | mRS at discharge |
---|---|---|---|---|---|---|---|---|---|---|---|---|
01 | 71, m | Left | lobar | 2 | – | – | 75 | 95 | 9 | 14 | No | 2 |
02 | 85, f | Left | Deep | 3 | PI | – | 17 | 95 | 11 | 13 | No | 4 |
03 | 80, f | Left | Lobar | 4 | PI | – | 41 | 134 | 10 | 14 | No | 3 |
04 | 78, f | Right | Lobar | 2 | PI | P | 47 | 59 | 11 | 11 | No | 3 |
05 | 63, m | Left | Deep | 3 | – | – | 23 | 147 | 8 | 12 | No | 5 |
06 | 64, f | Right | Deep | 3 | PI | P | 48 | 65 | 10 | 14 | No | 5 |
07 | 72, m | Left | Deep | 2 | – | – | 30 | 134 | 6 | 8 | No | 5 |
08 | 82, m | Right | Deep | 3 | NOAC | PCC | 11 | 168 | 14 | 8 | No | 4 |
09 | 51, f | Left | Deep | 4 | – | – | 76 | 120 | 6 | 8 | No | 4 |
10 | 81, f | Right | Deep | 2 | W | P + PCC | 69 | 54 | 9 | 6 | Yes | 6 |
11 | 75, f | Right | Deep | 3 | NOAC | PCC | 6 | 87 | 8 | 8 | Yes | 6 |
12 | 84, m | Right | Lobar | 3 | PI | P | 6 | 56 | 12 | 12 | No | 4 |
13 | 76, m | Left | Deep | 3 | PI | P | 8 | 120 | 10 | 3 | Yes | 6 |
14 | 58, f | Left | Lobar | 2 | – | – | 48 | 69 | 12 | 15 | No | 2 |
15 | 79, m | Left | Lobar | 1 | NOAC | PCC | 6 | 55 | 11 | 15 | No | 3 |
16 | 83, m | Left | Lobar | 3 | PI | P | 31 | 68 | 13 | 15 | No | 3 |
17 | 76, f | Right | Lobar | 1 | NOAC | PCC | 12 | 56 | 13 | 14 | No | 2 |
18 | 42, m | Right | Deep | 2 | – | – | 42 | 35 | 5 | 12 | No | 4 |
76 (42–85) | 3 (1–4) | 67% | 83% | 31 (6–76) | 90 ± 39 | 10 (5–14) | 12 (3–15) | 17% | 4 (2–6) |
Intraoperative imaging and efficiency of hematoma evacuation
No. | PreOP volume (ml) | IntraOP volume (ml) | Percent evacuation | PostOP volume (ml) | Percent evacuation | Device | Imaging | IntraOP control scan | IntraOP second look | Secondary revision surgery |
---|---|---|---|---|---|---|---|---|---|---|
01 | 31 | 1 | 97 | 1 | 97 | 1st gen. | iCT | Yes | No | No |
02 | 49 | 10 | 79 | 37 | 24 | 1st gen. | iCT | Yes | No | No |
03 | 53 | 16 | 70 | 18 | 66 | 1st gen. | iCT | Yes | No | No |
04 | 54 | N/A | N/A | 31 | 43 | 1st gen. | N/A | No | No | Yes |
05 | 43 | 10 | 78 | 17 | 62 | 1st gen. | iCT | Yes | No | No |
06 | 47 | 6 | 87 | 36 | 24 | 1st gen. | CBCT | Yes | Yes | No |
07 | 32 | 2 | 93 | 7 | 80 | 1st gen. | CBCT | Yes | No | No |
08 | 42 | 30 | 29 | 27 | 37 | 1st gen. | iCT | Yes | Yes | No |
09 | 38 | 1 | 97 | 4 | 91 | 1st gen. | CBCT | Yes | Yes | No |
10 | 21 | 1 | 95 | 20 | 7 | 1st gen. | CBCT | Yes | No | No |
11 | 92 | 8 | 91 | 21 | 77 | 1st gen. | CBCT | Yes | No | No |
12 | 92 | 22 | 76 | 36 | 60 | 1st gen. | CBCT | Yes | No | No |
13 | 125 | 69 | 44 | 164 | 0 | 1st gen. | CBCT | Yes | Yes | No |
14 | 41 | 7 | 83 | 5 | 88 | 2nd gen. | CBCT | Yes | No | No |
15 | 68 | 1 | 99 | 3 | 95 | 2nd gen. | CBCT | Yes | No | No |
16 | 66 | 21 | 68 | 31 | 53 | 2nd gen. | CBCT | Yes | Yes | No |
17 | 43 | 13 | 70 | 13 | 70 | 2nd gen. | CBCT | Yes | No | No |
18 | 39 | 1 | 97 | 5 | 87 | 2nd gen. | CBCT | Yes | No | No |
54 ± 26 | 13 ± 17 | 80 ± 19% | 26 ± 37 | 59 ± 30% | 94% | 29% | 6% |