TY  - BOOK
AU  - Chang, Jason J
TI  - Minimally invasive endoscopic hematoma evacuation vs best  medical management for spontaneous basal-ganglia intracerebral  hemorrhage
SN  - 1759-8478
PY  - 2019///
KW  - *Basal Ganglia Hemorrhage/dg [Diagnostic Imaging]
KW  - *Basal Ganglia Hemorrhage/th [Therapy]
KW  - *Disease Management
KW  - *Minimally Invasive Surgical Procedures/mt [Methods]
KW  - *Neuroendoscopy/mt [Methods]
KW  - Adult
KW  - Aged
KW  - Basal Ganglia Hemorrhage/mo [Mortality]
KW  - Case-Control Studies
KW  - Cohort Studies
KW  - Female
KW  - Hospital Mortality/td [Trends]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Minimally Invasive Surgical Procedures/mo [Mortality]
KW  - Minimally Invasive Surgical Procedures/st [Standards]
KW  - Neuroendoscopy/mo [Mortality]
KW  - Neuroendoscopy/st [Standards]
KW  - Pilot Projects
KW  - Prospective Studies
KW  - Retrospective Studies
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Surgery/Surgical Critical Care
KW  - Journal Article
N1  - Available online through MWHC library: 2009 - present
N2  - BACKGROUND: We conducted a case-control study to assess the  relative safety and efficacy of minimally invasive endoscopic surgery  (MIS) for clot evacuation in patients with basal-ganglia intracerebral  hemorrhage (ICH); CONCLUSIONS: Minimally invasive endoscopic hematoma  evacuation was associated with lower rates of in-hospital mortality in  patients with spontaneous basal-ganglia ICH. These findings support a  randomized controlled trial of MIS versus medical management for ICH; Copyright (c) Author(s) (or their employer(s)) 2019. No  commercial re-use. See rights and permissions. Published by BMJ; METHODS: We evaluated consecutive patients with acute  basal-ganglia ICH at a single center over a 42-month period. Patients  received either best medical management according to established  guidelines (controls) or MIS (cases). The following outcomes were  compared before and after propensity-score matching (PSM): in-hospital  mortality; discharge National Institutes of Health Stroke Scale score;  discharge disposition; and modified Rankin Scale scores at discharge  and at 3 months; RESULTS: Among 224 ICH patients, 19 (8.5%) underwent MIS  (mean age, 50.9+/-10.9; 26.3% female, median ICH volume, 40 (IQR, 25- 51)). The interventional cohort was younger with higher ICH volume and  stroke severity compared with the medically managed cohort. After PSM,  18 MIS patients were matched to 54 medically managed individuals. The  two cohorts did not differ in any of the baseline characteristics. The  median ICH volume at 24 hours was lower in the intervention group (40  cm<sup>3</sup> (IQR, 25-50) vs 15 cm<sup>3</sup> (IQR, 5-20);  P<0.001). The two cohorts did not differ in any of the pre-specified  outcomes measures except for in-hospital mortality, which was lower in  the interventional cohort (28% vs 56%; P=0.041)
UR  - https://dx.doi.org/10.1136/neurintsurg-2018-014447
ER  -