Comparison between Modified Neuroendoscopy and Craniotomy Evacuation of Spontaneous Intra-Cerebral Hemorrhages: Study of Clinical Outcome and Glasgow Outcome Score

Background: Stroke is still one of a leading health-care problem in industrial country and developing country. Spontaneous Intra-Cerebral Hemorrhage accounts for 30–60% of all stroke admissions and considered to be a poor prognostic factor. While the craniotomy procedure failed to show benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. Neuroendoscopy is one of promising optional on minimal invasive treatment for spontaneous intra-cerebral hemorrhage. Material and Methods: Randomized control trial was conducted to evaluate Glasgow Outcome Score and clinical outcome of patients with Spontaneous Intra-Cerebral Hemorrhage who underwent modified neuroendoscopic surgery and craniotomy. The removal of intra-cerebral hemorrhage was done by a modified neuroendoscopic transparent sheath made of silastic material, derived from pieces of thoracic tube No. 21F as a conduit working channel. Results: 43 patients were enrolled which 25 patients treated with neuroendoscopy surgery and 18 patients with craniotomy. The mortality rate was significantly higher , in craniotomy group n=12 (63.2%) compared with neuroendoscopy group, n=7 (36.8%) (p .005). Patients with Glasgow Outcome Scale score 3–5 was higher in neuroendoscopy group, n=18 (75%) compared with craniotomy group n=6 (25%). The survival rate analyzed by Kaplan Meier methods, found that patients in the neuroendoscopy group were a significantly longer survival rate compare with the craniotomy group during 6 months post operative follow-up period. Conclusions: Treatment of spontaneous intra-cerebral hemorrhage with modified neuroendoscopy procedure was faster in action, safer and had significantly higher survival rate compared with conventional one.