Comparative analysis of the efficacy of neuro-endoscopy versus conventional surgery in the treatment of hypertensive intracerebral hemorrhage.

Background: There are multiple therapeutic approaches for hypertensive intracerebral hemorrhage, including neuro-endoscopy and traditional craniotomy. This study aims to compare the efficacy and prognosis of these two modalities in managing hypertensive intracerebral hemorrhage.

Method: By retrospectively analyzing data from two medical centers, we comprehensively investigated patients who underwent surgical intervention for spontaneous cerebral hemorrhage within 48 h of admission between June 2021 and May 2024. A total of 285 patients diagnosed with HICH were included in this study, divided into two groups (endoscopic surgery group and traditional surgery group). Comparative analyses were conducted to assess differences in baseline characteristics, clinical outcomes, prognosis, and neurological function between the two groups.

Results: Among the 285 eligible patients, we conducted endoscopic surgery and traditional open craniotomy. The baseline table indicates no statistically significant difference between the two groups regarding bleeding volume and admission GCS score (p > 0.05). Compared to the traditional surgery group, the neuro-endoscopic surgery group demonstrates advantages in operation time (105.25 ± 10.6 vs. 154.33 ± 22.64, p < 0.01), surgical bleeding volume (89.65 ± 34.96 vs. 175.35 ± 67.6, p < 0.01), hospital stay time (16.73 ± 2.38 vs. 20.4 ± 4.6, p < 0.01), hematoma clearance rate (92.7 ± 3.15 vs. 87.6 ± 6.4, p < 0.01), and hospital expenses (9 ± 2.02 vs. 13.8 ± 2.6, p = 0.001). The neuro-endoscopy group can bring better long-term benefits compared to the traditional surgical group. (p<0.05).

Conclusions: Our findings suggest that neuroendoscopy may improve long-term prognosis compared to conventional surgical approaches. The utilization of neuro-endoscopy in patients with hypertensive intracerebral hemorrhage significantly enhances the rate of hematoma clearance, reduces intraoperative bleeding and surgical time, shortens hospital stay, and lowers hospitalization expenses.