Analysis of three surgical methods for the treatment of spontaneous supratentorial intracerebral hemorrhage

Goal. This retrospective study aimed to evaluate the efficacy and safety of three surgical interventions for spontaneous supratentorial intracerebral hemorrhage. Materials and methods. A total of 63 patients with supratentorial intracerebral hemorrhage were randomly assigned to 3 groups. Group A (n = 21) underwent cranial trepanation, group B (n = 22) underwent perforation, urokinase infusion and catheter drainage, and group C (n = 20) underwent neuroendoscopic surgery. The rate of hematoma removal during surgery was analyzed using 3D Slice software, and the average surgery time, imaging during surgery, decompressive effect, mortality, improvement on the Glasgow Coma Scale, complications such as repeated bleeding, pneumonia, and intracranial infection were also compared between the three groups. Results. All procedures were successfully completed, and the hematoma removal rate had significant differences between the 3 groups, which were 79.8%, 43.1%, and 89.3%, respectively (P<0.01), with group C being the highest. Group B was the least traumatic and had the shortest surgery time, but due to the lack of hemostasis, she also had more recurrent bleeding (P = 0.03). Despite the fact that the complications were different, there were no significant changes in terms of pneumonia, intracranial infection, improvement in general condition and mortality. Conclusion. All of these three methods had their advantages and disadvantages, and each approach had its own indications for supratentorial intracerebral hemorrhage. Although due to the minimally invasive neuroendoscopic technique, direct view, effective hematoma removal rate, and relatively optimistic outcome, this approach may be more promising for the treatment of intracerebral hemorrhages