{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:36:36Z","timestamp":1789799796171,"version":"4.0.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Primary spontaneous Intracerebral Hemorrhage (PSICH) is a devastating disease occurring in 24.6 cases per 100,000 people per year, more common with chronic arterial hypertension. Emergent hematoma evacuation remains a lifesaving intervention especially in younger patients with large hematoma volume and are clinically deteriorating. Timely and appropriate management is key to improving outcomes. In this study, we compared whether conventional craniotomy or neuroendoscopic surgery would lead to improved mortality and better functional outcomes in patients with PSICH. Specifically, we wanted to determine the extent of hematoma clearance, intraoperative blood loss, intraoperative time, degree of rebleeding, total complications, and length of hospital stay among the surgical approaches utilized. We searched from the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE\/PubMed, the U.S. National Institutes of Health Ongoing Trials Register, Embase database, Health Research and Development Information Network (HERDIN), and the World Health Organization International Clinical Trials Registry Platform for studies to be included. Patients with deep hypertensive intracerebral hemorrhage of either sex, aged 18 to 60 years, with a Glasgow Coma Score of 6 to 12, with hematoma volume of 30 to 80\u2009mL, and received treatment within 24\u2009hours with either conventional craniotomy or neuroendoscopic surgery were allowed. Outcomes evaluated were mortality and functional outcome. The risk of bias was assessed using the ROBINS-I tool for nonrandomized studies. The final search yielded four eligible studies. Both conventional craniotomy and neuroendoscopic surgery did not show any statistically significant difference in postoperative mortality (risk ratio [RR]: 1.32, 95% confidence interval [CI]: 0.48\u20133.62, p\u2009=\u20090.59, I2: 42%) and postoperative functional outcome (RR: 3.17, 95% CI: 0.76\u201313.3, p\u2009=\u20090.11, I2: 83%). Neuroendoscopic surgery showed statistically significant shorter operative time. Both interventions yielded similar results in amount of volume evacuated, intraoperative blood loss, length of hospital stay, number of rebleeding, and total complications. This meta-analysis and review shows that conventional craniotomy and neuroendoscopic surgery both lead to good postoperative functional outcomes with similar death rates. Neuroendoscopic surgery showed statistically significant shorter operative time. Both interventions result in high volume of hematoma evacuated, low number of rebleeding, and total complications, as well as similar amount of intraoperative blood loss and length of hospital stay.<\/jats:p>","DOI":"10.1055\/s-0045-1809166","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T20:12:11Z","timestamp":1747771931000},"page":"478-484","source":"Crossref","is-referenced-by-count":4,"title":["Conventional Craniotomy and Neuroendoscopic Surgery for Patients with Hypertensive Intracerebral Hemorrhage: A Meta-analysis and Systematic Review"],"prefix":"10.1055","volume":"20","author":[{"given":"John Emmanuel Y.","family":"Custodio","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, Jose R. Reyes Memorial Medical Center, Santa Cruz, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Erroll V.","family":"Navarro","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, Jose R. Reyes Memorial Medical Center, Santa Cruz, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver Ryan M.","family":"Malilay","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, Jose R. Reyes Memorial Medical Center, Santa Cruz, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"105617","DOI":"10.1016\/j.clineuro.2019.105617","article-title":"Different surgical interventions for patients with spontaneous supratentorial intracranial hemorrhage: a network meta-analysis","volume":"188","author":"M Li","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1515\/tnsci-2020-0173","article-title":"Intracerebral hemorrhage with tentorial herniation: conventional open surgery or emergency stereotactic craniopuncture aspiration surgery?","volume":"12","author":"J Shi","year":"2021","journal-title":"Transl 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outcome","volume":"46","author":"Y Z Kim","year":"2009","journal-title":"J Korean Neurosurg Soc"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/1471-2377-11-76","article-title":"A prospective controlled study: minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage","volume":"11","author":"H Zhou","year":"2011","journal-title":"BMC Neurol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1016\/j.wneu.2018.02.056","article-title":"Surgical management of supratentorial intracerebral hemorrhages: endoscopic versus open surgery","volume":"114","author":"U Eroglu","year":"2018","journal-title":"World Neurosurg"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1017\/cjn.2021.185","article-title":"3D-Printed endoport vs. open surgery for evacuation of deep intracerebral hemorrhage","volume":"49","author":"E Garcia-Estrada","year":"2022","journal-title":"Can J Neurol Sci"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s12893-022-01642-8","article-title":"Neuroendoscopic-assisted versus mini-open craniotomy for hypertensive intracerebral hemorrhage: a retrospective analysis","volume":"22","author":"W Lu","year":"2022","journal-title":"BMC Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"e14123","DOI":"10.1097\/MD.0000000000014123","article-title":"Comparison of keyhole endoscopy and craniotomy for the treatment of patients with hypertensive cerebral hemorrhage","volume":"98","author":"G Sun","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"677","DOI":"10.12669\/pjms.323.9533","article-title":"Clinical effect of minimally invasive intracranial hematoma in treating hypertensive cerebral hemorrhage","volume":"32","author":"G 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spontaneous intracerebral hemorrhage: a single-center retrospective study","volume":"47","author":"S Liu","year":"2023","journal-title":"Neurosurg Rev"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.wneu.2018.02.022","article-title":"Effect and feasibility of endoscopic surgery in spontaneous intracerebral hemorrhage: a systematic review and meta-analysis","volume":"113","author":"Z Yao","year":"2018","journal-title":"World Neurosurg"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1055\/s-0033-1348348","article-title":"Outcomes after endoscopic port surgery for spontaneous intracerebral hematomas","volume":"75","author":"P Ochalski","year":"2014","journal-title":"J Neurol Surg A Cent Eur Neurosurg"}],"container-title":["Asian Journal of 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