{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:26:55Z","timestamp":1777642015575,"version":"3.51.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012230","name":"Water Resources Department of Guangdong Province","doi-asserted-by":"crossref","award":["2015A030313259"],"award-info":[{"award-number":["2015A030313259"]}],"id":[{"id":"10.13039\/501100012230","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key Project of Clinical Research of Southern Medical University","award":["LC2016PY59"],"award-info":[{"award-number":["LC2016PY59"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Decompressive craniectomy (DC) is performed conventionally for large putaminal intracerebral hemorrhage (ICH). However, DC causes local skull defect and leads to post-surgical cranioplasty. The aim of this study is to investigate the effectiveness and safety of an endoscopic procedure to treat large putaminal ICH without DC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 112 large putaminal ICH patients who underwent hematoma evacuations with either an endoscopic procedure (group A) or with DC (group B) between January 2009 and June 2017. The efficacy was evaluated by mean modified Rankin Scale (mRS) three months after surgery. Safety was evaluated by mortality rate and postoperative complications. Univariate and multivariate logistic regression analyses were performed to determine the risk factors for clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 49 patients in group A and 63 in group B. The mRS scores in both groups were similar after 3 months\u2019 follow-up (<jats:italic>p<\/jats:italic>\u2009=\u20090.709). There was no difference in the mortality rate between the two groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.538). The rate of complications was lower in group A than that in group B (<jats:italic>p<\/jats:italic>\u2009=\u20090.024). Smaller preoperative midline shift (<jats:italic>p<\/jats:italic>\u2009=\u20090.008) and absent intraventricular extension (<jats:italic>p<\/jats:italic>\u2009=\u20090.044) have contributed significantly to better outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic hematoma evacuation without DC is safe and effective for patients with large putaminal ICH and deserves further investigation, preferably in a randomized controlled setting.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s12028-019-00880-8","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T20:04:01Z","timestamp":1576526641000},"page":"392-399","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Endoscopic Surgery Without Decompressive Craniectomy in Large Putaminal Intracerebral Hemorrhage: Assessment of Efficacy and Safety"],"prefix":"10.1007","volume":"32","author":[{"given":"Yuanliang","family":"Ye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiujing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiyang","family":"Ou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenhui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"key":"880_CR1","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/S1474-4422(09)70025-0","volume":"8","author":"VL Feigin","year":"2009","unstructured":"Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355\u201369.","journal-title":"Lancet Neurol"},{"key":"880_CR2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S1474-4422(09)70340-0","volume":"9","author":"CJ van Asch","year":"2010","unstructured":"van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167\u201376.","journal-title":"Lancet Neurol"},{"key":"880_CR3","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s10143-017-0909-x","volume":"41","author":"A Hadjiathanasiou","year":"2018","unstructured":"Hadjiathanasiou A, Schuss P, Ilic I, Borger V, Vatter H, Guresir E. Decompressive craniectomy for intracerebral haematoma: the influence of additional haematoma evacuation. Neurosurg Rev. 2018;41:649\u201354.","journal-title":"Neurosurg Rev"},{"key":"880_CR4","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1179\/016164102101199549","volume":"24","author":"G Maira","year":"2002","unstructured":"Maira G, Anile C, Colosimo C, Rossi GF. Surgical treatment of primary supratentorial intracerebral hemorrhage in stuporous and comatose patients. Neurol Res. 2002;24:54\u201360.","journal-title":"Neurol Res"},{"key":"880_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jstrokecerebrovasdis.2008.09.001","volume":"18","author":"R Ramnarayan","year":"2009","unstructured":"Ramnarayan R, Anto D, Anilkumar TV, Nayar R. Decompressive hemicraniectomy in large putaminal hematomas: an Indian experience. J Stroke Cerebrovasc Dis Offic J Natl Stroke Assoc. 2009;18:1\u201310.","journal-title":"J Stroke Cerebrovasc Dis Offic J Natl Stroke Assoc"},{"key":"880_CR6","doi-asserted-by":"publisher","first-page":"819","DOI":"10.2176\/nmc.oa.2014-0136","volume":"55","author":"S Yamashiro","year":"2015","unstructured":"Yamashiro S, Hitoshi Y, Yoshida A, Kuratsu J. Effectiveness of endoscopic surgery for comatose patients with large supratentorial intracerebral hemorrhages. Neurol Med Chir. 2015;55:819\u201323.","journal-title":"Neurol Med Chir"},{"key":"880_CR7","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1016\/j.clineuro.2013.02.005","volume":"115","author":"HT Zhang","year":"2013","unstructured":"Zhang HT, Xue S, Li PJ, Fu YB, Xu RX. Treatment of huge hypertensive putaminal hemorrhage by surgery and cerebrospinal fluid drainage. Clin Neurol Neurosurg. 2013;115:1602\u20138.","journal-title":"Clin Neurol Neurosurg"},{"key":"880_CR8","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1161\/STR.0000000000000069","volume":"46","author":"JC Hemphill 3rd","year":"2015","unstructured":"Hemphill JC 3rd, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2015;46:2032\u201360.","journal-title":"Stroke"},{"key":"880_CR9","first-page":"1338","volume":"16","author":"CC Chen","year":"2009","unstructured":"Chen CC, Chung HC, Liu CL, Lee HC, Cho DY. A newly developed endoscopic sheath for the removal of large putaminal hematomas. J Clin Neurosci Offic J Neurosurg Soc Australas. 2009;16:1338\u201341.","journal-title":"J Clin Neurosci Offic J Neurosurg Soc Australas"},{"key":"880_CR10","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.surneu.2007.12.016","volume":"69","author":"CM Miller","year":"2008","unstructured":"Miller CM, Vespa P, Saver JL, et al. Image-guided endoscopic evacuation of spontaneous intracerebral hemorrhage. Surg Neurol. 2008;69:441\u20136 (discussion 6).","journal-title":"Surg Neurol"},{"key":"880_CR11","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.3171\/jns.2000.92.6.1053","volume":"92","author":"T Nishihara","year":"2000","unstructured":"Nishihara T, Teraoka A, Morita A, Ueki K, Takai K, Kirino T. A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas. Technical note. J Neurosurg. 2000;92:1053\u20135.","journal-title":"J Neurosurg"},{"key":"880_CR12","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1007\/s12028-014-9987-6","volume":"21","author":"B Orakcioglu","year":"2014","unstructured":"Orakcioglu B, Beynon C, Bosel J, Stock C, Unterberg AW. Minimally invasive endoscopic surgery for treatment of spontaneous intracerebral hematomas: a single-center analysis. Neurocrit Care. 2014;21:407\u201316.","journal-title":"Neurocrit Care"},{"key":"880_CR13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/978-3-7091-0661-7_1","volume":"112","author":"B Orakcioglu","year":"2011","unstructured":"Orakcioglu B, Uozumi Y, Unterberg A. Endoscopic intra-hematomal evacuation of intracerebral hematomas\u2014a suitable technique for patients with coagulopathies. Acta Neurochir Suppl. 2011;112:3\u20138.","journal-title":"Acta Neurochir Suppl"},{"key":"880_CR14","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3171\/2016.7.JNS16932","volume":"127","author":"GC Sun","year":"2017","unstructured":"Sun GC, Chen XL, Hou YZ, et al. Image-guided endoscopic surgery for spontaneous supratentorial intracerebral hematoma. J Neurosurg. 2017;127:537\u201342.","journal-title":"J Neurosurg"},{"key":"880_CR15","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.wneu.2016.07.015","volume":"94","author":"FF Angileri","year":"2016","unstructured":"Angileri FF, Esposito F, Priola SM, et al. Fully endoscopic freehand evacuation of spontaneous supratentorial intraparenchymal hemorrhage. World Neurosurg. 2016;94:268\u201372.","journal-title":"World Neurosurg"},{"key":"880_CR16","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jcma.2014.08.013","volume":"78","author":"WH Wang","year":"2015","unstructured":"Wang WH, Hung YC, Hsu SP, et al. Endoscopic hematoma evacuation in patients with spontaneous supratentorial intracerebral hemorrhage. J Chin Med Assoc JCMA. 2015;78:101\u20137.","journal-title":"J Chin Med Assoc JCMA"},{"key":"880_CR17","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.3171\/2014.10.JNS14915","volume":"123","author":"K Yokosuka","year":"2015","unstructured":"Yokosuka K, Uno M, Matsumura K, et al. Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients. J Neurosurg. 2015;123:1065\u20139.","journal-title":"J Neurosurg"},{"key":"880_CR18","doi-asserted-by":"publisher","first-page":"543","DOI":"10.2176\/nmc.51.543","volume":"51","author":"K Yokosuka","year":"2011","unstructured":"Yokosuka K, Uno M, Hirano K, Toi H, Matsuzaki K, Matsubara S. Freehand technique for putaminal hemorrhage\u2014technical note. Neurol Med Chir. 2011;51:543\u20136.","journal-title":"Neurol Med Chir"},{"key":"880_CR19","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/2011.2.FOCUS10313","volume":"30","author":"LT Kuo","year":"2011","unstructured":"Kuo LT, Chen CM, Li CH, et al. Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results. Neurosurg Focus. 2011;30:E9.","journal-title":"Neurosurg Focus"},{"key":"880_CR20","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.wneu.2016.04.066","volume":"91","author":"L Liu","year":"2016","unstructured":"Liu L, Liu X, Zhang F, et al. Dual-channel minimally invasive endoscopic port for evacuation of deep-seated spontaneous intracerebral hemorrhage with obstructive hydrocephalus. World Neurosurg. 2016;91:452\u20139.","journal-title":"World Neurosurg"},{"key":"880_CR21","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/s00701-008-1561-6","volume":"150","author":"T Nagasaka","year":"2008","unstructured":"Nagasaka T, Inao S, Ikeda H, Tsugeno M, Okamoto T. Inflation-deflation method for endoscopic evacuation of intracerebral haematoma. Acta Neurochir (Wien). 2008;150:685\u201390 (discussion 90).","journal-title":"Acta Neurochir (Wien)"},{"key":"880_CR22","doi-asserted-by":"publisher","first-page":"E826","DOI":"10.1227\/01.NEU.0000350985.58062.3F","volume":"65","author":"T Nagasaka","year":"2009","unstructured":"Nagasaka T, Tsugeno M, Ikeda H, et al. Balanced irrigation-suction technique with a multifunctional suction cannula and its application for intraoperative hemorrhage in endoscopic evacuation of intracerebral hematomas: technical note. Neurosurgery. 2009;65:E826\u20137 (discussion E7).","journal-title":"Neurosurgery"},{"key":"880_CR23","doi-asserted-by":"publisher","first-page":"2631","DOI":"10.1161\/01.STR.0000035284.12699.84","volume":"33","author":"JM Gebel Jr","year":"2002","unstructured":"Gebel JM Jr, Jauch EC, Brott TG, et al. Natural history of perihematomal edema in patients with hyperacute spontaneous intracerebral hemorrhage. Stroke. 2002;33:2631\u20135.","journal-title":"Stroke"},{"key":"880_CR24","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.3171\/2017.1.JNS161840","volume":"128","author":"ST Lubillo","year":"2018","unstructured":"Lubillo ST, Parrilla DM, Blanco J, et al. Prognostic value of changes in brain tissue oxygen pressure before and after decompressive craniectomy following severe traumatic brain injury. J Neurosurg. 2018;128:1538\u201346.","journal-title":"J Neurosurg"},{"key":"880_CR25","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/978-3-7091-1434-6_53","volume":"118","author":"S Takeuchi","year":"2013","unstructured":"Takeuchi S, Takasato Y, Masaoka H, et al. Decompressive craniectomy with hematoma evacuation for large hemispheric hypertensive intracerebral hemorrhage. Acta Neurochir Suppl. 2013;118:277\u20139.","journal-title":"Acta Neurochir Suppl"},{"key":"880_CR26","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1007\/978-3-7091-0693-8_71","volume":"111","author":"N Shimamura","year":"2011","unstructured":"Shimamura N, Munakata A, Naraoka M, Nakano T, Ohkuma H. Decompressive hemi-craniectomy is not necessary to rescue supratentorial hypertensive intracerebral hemorrhage patients: consecutive single-center experience. Acta Neurochir Suppl. 2011;111:415\u20139.","journal-title":"Acta Neurochir Suppl"},{"key":"880_CR27","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s12028-007-9033-z","volume":"9","author":"PT Akins","year":"2008","unstructured":"Akins PT, Guppy KH. Sinking skin flaps, paradoxical herniation, and external brain tamponade: a review of decompressive craniectomy management. Neurocrit Care. 2008;9:269\u201376.","journal-title":"Neurocrit Care"},{"key":"880_CR28","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.3171\/foc.2004.16.6.8","volume":"16","author":"A Bakshi","year":"2004","unstructured":"Bakshi A, Bakshi A, Banerji AK. Neuroendoscope-assisted evacuation of large intracerebral hematomas: introduction of a new, minimally invasive technique. Preliminary report. Neurosurg Focus. 2004;16:e9.","journal-title":"Neurosurg Focus"},{"key":"880_CR29","doi-asserted-by":"publisher","first-page":"244","DOI":"10.3340\/jkns.2010.48.3.244","volume":"48","author":"SP Ban","year":"2010","unstructured":"Ban SP, Son YJ, Yang HJ, Chung YS, Lee SH, Han DH. Analysis of complications following decompressive craniectomy for traumatic brain injury. J Korean Neurosurg Soc. 2010;48:244\u201350.","journal-title":"J Korean Neurosurg Soc"},{"key":"880_CR30","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1007\/s00701-008-0145-9","volume":"150","author":"XF Yang","year":"2008","unstructured":"Yang XF, Wen L, Shen F, et al. Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases. Acta Neurochir (Wien). 2008;150:1241\u20137 (discussion 8).","journal-title":"Acta Neurochir (Wien)"},{"key":"880_CR31","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.clineuro.2012.05.026","volume":"115","author":"S Takeuchi","year":"2013","unstructured":"Takeuchi S, Nawashiro H, Wada K, et al. Ventriculomegaly after decompressive craniectomy with hematoma evacuation for large hemispheric hypertensive intracerebral hemorrhage. Clin Neurol Neurosurg. 2013;115:317\u201322.","journal-title":"Clin Neurol Neurosurg"}],"container-title":["Neurocritical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-019-00880-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12028-019-00880-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-019-00880-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T03:01:42Z","timestamp":1695524502000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12028-019-00880-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,16]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["880"],"URL":"https:\/\/doi.org\/10.1007\/s12028-019-00880-8","relation":{},"ISSN":["1541-6933","1556-0961"],"issn-type":[{"value":"1541-6933","type":"print"},{"value":"1556-0961","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,16]]},"assertion":[{"value":"16 December 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was approved by the ethics committee of Zhujiang Hospital, Southern Medical University. Informed consent was obtained by the ethics committees. The family members signed the written surgical consent before surgery.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval\/Informed consent"}}]}}