+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Computed tomography-guided aspiration versus key-hole craniotomy for spontaneous putaminal haemorrhage: a prospective comparison of minimally invasive procedures



Computed tomography-guided aspiration versus key-hole craniotomy for spontaneous putaminal haemorrhage: a prospective comparison of minimally invasive procedures



Hong Kong Medical Journal 15(4): 274-279



To compare the effectiveness of two minimally invasive procedures, namely computed tomography-guided aspiration and the key-hole approach, in the neurosurgical management for spontaneous putaminal haemorrhage, and to explore the indications for the two approaches. A multicentre, single-blinded controlled trial. Hospitals taking part in this trial and the sources for patients were from China. Among others, the hospitals involved in the interventions included: the Beijing Tiantan Hospital (of the Capital University of Medical Sciences), the General Hospital of People's Liberation Army, the Peking Union Hospital, and the Shanghai Huashan Hospital (of the Fudan University medical school). From September 2001 to November 2003, data were available for analysis from a total of 841 patients with spontaneous putaminal haemorrhage from 135 hospitals all over China (except Tibet, Hong Kong, Taiwan, and Macao). All follow-up data were for at least 3 months. Mortality, Glasgow Coma Scale score, postoperative complications, Kanofsky Performance Scale score, and Barthel Index. There were 563 patients who underwent computed tomography-guided aspiration, and 165 were treated by the key-hole approach. Respective mortality rates 1 month after the operation were 17.9% and 18.3%; at 3 months they were 19.4% and 19.4%. In those undergoing computed tomography-guided aspiration, mortality rates at 3 months after the operation were 28.2% in patients with Glasgow Coma Scale scores of 8 or below, as opposed to 8.2% in those with higher scores. This amounted to a 3.4-fold difference. In those treated by the key-hole approach, the corresponding rates were 30.2% and 7.6%, which amounted to a 4-fold difference. The corresponding mortality at 3 months in patients with complications was 3.9 times as great as in those without complications. In those with haematoma volumes of 70 mL or greater, it was 2.7 times as much as in those in whom the volumes below 30 mL. The postoperative complication rate of computed tomography-guided aspiration (23.7%) did not differ significantly from that in those having the key-hole approach (25.7%) [P=0.420]. Computed tomography-guided aspiration is not superior to the key-hole approach for treating spontaneous putaminal haemorrhage in terms of favourable outcomes, mortality, and morbidity. However, it could be the first-choice approach for those with bleeds of 50 mL or less, while the key-hole approach may be more suitable for those with larger haematomas.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 052277056

Download citation: RISBibTeXText

PMID: 19652234


Related references

Comparison of CT-guided aspiration to key hole craniotomy in the surgical treatment of spontaneous putaminal hemorrhage: a prospective randomized study. Frontiers of Medicine in China 1(2): 142-146, 2007

Critical clinical appraisal of the role of computed tomography-guided minimally invasive aspiration cytology in evaluation of retroperitoneal masses. Indian Journal of Medical and Paediatric Oncology 35(1): 60-65, 2014

An Outcome and Cost Analysis Comparing Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Intraoperative Fluoroscopy versus Computed Tomography-Guided Navigation. World Neurosurgery 94: 255-260, 2016

Utility of computed tomography guided abdominal aspiration procedures. AJR (American Journal of Roentgenology) 139(6): 1111-1115, 1982

Computed tomography guided aspiration procedures in the central nervous system. Journal Of Computer Assisted Tomography: 571, 1979

Minimally invasive treatment of spontaneous intracerebral haemorrhage Stereotactic aspiration combined with clot lysis using recombinant tissue-plasminogen activator. Stereotactic & Functional Neurosurgery 67(1-2): 39-40, 1996 ( ), 1997

Comparison of stereotactic aspiration, craniotomy, and conservative treatment for putaminal hemorrhage. Neurologia Medico-Chirurgica 28(10): 986-990, 1988

A simple stabilization device for intracranial aspiration procedures guided by computed tomography. Radiology 144(1): 183-184, 1982

A prospective controlled study: minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage. Bmc Neurology 11: 76, 2011

Computed tomography-guided drainage of a corpus cavernosum abscess: a minimally invasive successful treatment. Cardiovascular and Interventional Radiology 34(1): 217-219, 2011

Percutaneous computed tomography-guided aspiration and biopsy of intrathoracic lesions: Results of 265 procedures. Lung India 33(6): 620-625, 2016

Pain in the air: successful computed tomography-guided aspiration in a case of spontaneous pneumorrhachis. Spine Journal 12(10): 969-970, 2012

Removal of osteosynthesis material by minimally invasive surgery based on 3-dimensional computed tomography-guided navigation. Journal of Oral and Maxillofacial Surgery 61(3): 401-405, 2003

Computed Tomography Guided Hook-wire Precise Localization and Minimally Invasive Resection of Pulmonary Nodules. Zhongguo Fei Ai Za Zhi 18(11): 680-685, 2015

A three-dimensional stereotactic device for computed tomography-guided invasive diagnostic and therapeutic procedures. Investigative Radiology 28(9): 845-847, 1993