MINIMALLY INVASIVE SURGICAL APPROACHES IN INTRACEREBRAL HEMORRHAGE
Keywords:
Intracerebral hemorrhage, minimally invasive surgery, stereotactic aspiration, endoscopic evacuation, catheter-based therapy, neurosurgery, stroke managementAbstract
Intracerebral hemorrhage (ICH) remains one of the most severe forms of stroke, associated with high rates of morbidity and mortality. Conventional surgical techniques, such as craniotomy, while effective in selected cases, often carry significant risks, particularly in critically ill patients. In recent years, minimally invasive surgical approaches have emerged as promising alternatives for the management of ICH. These techniques, including stereotactic aspiration, endoscopic evacuation, and catheter-based thrombolysis, aim to reduce surgical trauma, minimize neurological deficits, and improve functional outcomes. This article reviews the current minimally invasive methods for treating ICH, their clinical efficacy, and the potential advantages and limitations compared to traditional approaches.
References
1. Awad, I. A., Polster, S. P., Carrión-Penagos, J., & Thompson, R. E. (2019). Surgical techniques for evacuating intracerebral hemorrhage. Stroke, 50(9), 2682–2691. https://doi.org/10.1161/STROKEAHA.119.024981
2. Hanley, D. F., Thompson, R. E., Rosenblum, M., Yenokyan, G., Lane, K., McBee, N., … MISTIE III Investigators. (2019). Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): A randomised, controlled, open-label, phase 3 trial. The Lancet, 393(10175), 1021–1032. https://doi.org/10.1016/S0140-6736(19)30195-3
3. Kellner, C. P., Sauvageau, E., Snyder, K. V., Fargen, K. M., Arthur, A. S., Bain, M., … Mocco, J. (2018). The promise of minimally invasive surgery for intracerebral hemorrhage. Neurosurgical Focus, 44(6), E2. https://doi.org/10.3171/2018.3.FOCUS18109
4. Scaggiante, J., Zhang, X., Mocco, J., & Kellner, C. P. (2018). Minimally invasive surgery for intracerebral hemorrhage. Stroke, 49(11), 2612–2620. https://doi.org/10.1161/STROKEAHA.118.020688
5. Zhou, X., Chen, J., Li, Q., Ren, G., Yao, G., Liu, M., … Hu, X. (2012). Minimally invasive surgery for spontaneous supratentorial intracerebral hemorrhage: A meta-analysis of randomized controlled trials. Stroke, 43(11), 2923–2930. https://doi.org/10.1161/STROKEAHA.112.663708