{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:21:23Z","timestamp":1789464083515,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":257,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stroke Research and Treatment"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The standard treatment of brainstem hemorrhage (BH) remains a controversial subject, and the optimal treatment strategy remains unclear. Stereotactic aspiration of a hematoma is one of the most used techniques in BH management. This review aims to update existing knowledge on the comparison of aspiration and standard treatments for BH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review updates a previous meta\u2010analysis on this subject. Four medical databases were searched from inception, and meta\u2010analysis was performed with a random\u2010effects model. Odds ratios (ORs) and mean differences (MDs) were applied for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 15 studies were included in this review. There was a significant reduction in total mortality (OR 0.26, 95% CI 0.17\u20130.41,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), mortality rate at 1\u2010month follow\u2010up (OR 0.32, 95% CI 0.22\u20130.46,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and an increased proportion of patients with mRS \u2264\u20093 (OR 2.69, 95% CI 1.57\u20134.59,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) in the surgical group compared with standard treatment. Meta\u2010regression revealed a significant correlation between GCS at admission and total mortality. There was no significant difference in rebleeding, stress ulcers, central hyperthermia, length of hospital stay, or respiratory complications. Trial sequential analysis showed a true\u2010positive result for mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stereotactic surgery is becoming a promising method for the treatment of BH. The results of this synthesis suggest that patients undergoing invasive treatment have higher survival rates and better functional outcomes compared with usual care. Although stereotactic aspiration yielded a higher survival in the meta\u2010analysis, quality concerns, false\u2010positive results for patients with mRS \u2264\u20093, and heterogeneity need to be acknowledged.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/srat\/3765769","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:15:45Z","timestamp":1789460145000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stereotactic Hematoma Aspiration Versus Standard Treatment for Brainstem Hemorrhage\u2014Updated Meta\u2010Analysis, Meta\u2010Regression, and Trial Sequential Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-5417","authenticated-orcid":false,"given":"Pawe\u0142","family":"\u0141ajczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9155-8471","authenticated-orcid":false,"given":"Ayesha","family":"Ayesha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0001-0390","authenticated-orcid":false,"given":"Oguz K.","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"\u0141ajczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6678-7349","authenticated-orcid":false,"given":"Mable","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_14_1_2","volume-title":"Neuroanatomy, Brainstem","author":"Basinger H.","year":"2023"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.26599\/JNR.2020.9040024"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4293590"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2024.108583"},{"key":"e_1_2_14_5_2","first-page":"733","article-title":"Stereotactic Aspiration in Hypertensive Pontine Hemorrhage: Comparative Study With Conservative Therapy","volume":"17","author":"Takahama H.","year":"1989","journal-title":"No Shinkei Geka Neurological Surgery"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-021-01683-2"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30195-3"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-023-06866-x"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_14_11_2","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J. 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