Successful Puncture and Drainage of Primary Brainstem Hemorrhage With Robotic Assistance.

Abstract

Primary brainstem hemorrhage (PBH) is characterized by sudden onset, rapid progression, and high mortality. The optimal therapeutic strategy for PBH remains controversial. This case report demonstrates the safety and efficacy of robot-assisted stereotactic puncture and drainage for PBH. A 56-year-old female presented with sudden-onset unconsciousness persisting for 48 hours. Noncontrast cranial computed tomography (CT) revealed a pontine hemorrhage. On the basis of hematoma location and clinical status, robot-assisted stereotactic puncture and drainage was performed. Postoperatively, the patient exhibited gradual neurological improvement without new deficits. At the 3-month follow-up, the patient regained consciousness but required substantial assistance for activities of daily living. Current management focuses on intensive rehabilitation with ongoing clinical surveillance. This case suggests that robot-assisted drainage may enhance procedural safety and efficacy in PBH, potentially improving survival and long-term functional outcomes.