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J Neurol Surg A Cent Eur Neurosurg 2025; 86(02): 111-119
DOI: 10.1055/a-2235-5453
Original Article

Robotic Frameless Stereotactic Aspiration with Thrombolysis for Primary Pontine Hemorrhage: A Therapeutic Evaluation of a Retrospective Cohort Study

Chongxi Xu  ‡   *
1   Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Wenbo He‡   *
1   Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Tong Yi
2   Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Hongtian Zhang
3   Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
4   The affiliated Bayi Brain Hospital, The 7th Medical Center, PLA General Hospital, Beijing, China
,
Jianguo Xu 
1   Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Junpeng Ma
1   Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
› Institutsangaben Funding This study was supported by General Program of the National Natural Science Foundation of China (grant nos.: 82173175 and 82001320), Knowledge Innovation Program of the Chinese Academy of Sciences (grant no.: JH2022007), 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (grant no. 2020HXFH036), and Key R&D projects in Sichuan province (2022YFS0319).
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Abstract

Background There is still no consensus on whether primary pontine hemorrhage (PPH) should be managed conservatively or treated promptly via surgical evacuation of the hematoma. The purpose of this study was to assess the therapeutic effect of robotic frameless stereotactic aspiration with thrombolysis in the treatment of PPH.

Methods A total of 39 patients with PPH treated between January 2012 and November 2016 were included in the study. Sixteen patients underwent frameless stereotactic surgical treatment (ST group) and 23 patients underwent conservative treatment (CT group). Clinical and radiologic parameters were assessed, and the patient outcomes were analyzed over a 6-month follow-up period.

Results Surgical treatment did not result in any intracranial infections, or complications. Baseline characteristics did not significantly differ between the two groups. At discharge, the average Glasgow Coma Scale (GCS) score and the overall Glasgow Outcome Scale (GOS) score were significantly higher in the ST group compared to the CT group (p < 0.05). The mortality rate (GOS score 1) was significantly lower in the ST group (18.75%, 3/16) than in the CT group (52.17%, 12/23). For patients with hematoma volumes of 5 to 10 mL or GCS scores of 6 to 8, following treatment, the ST group exhibited markedly higher GOS scores in comparison to the CT group.

Conclusion Our study suggests that robotic frameless stereotactic aspiration with thrombolysis is a safe and efficient method for the treatment of PPH. Patients with hematomas of 5 to 10 mL or GCS scores of 6 to 8 could benefit from surgery.

Keywords

primary pontine hemorrhage - stereotactic aspiration - robot - safety - functional outcome

Study Approval Statement

This study was conducted ethically in accordance with the guidelines for human studies and the World Medical Association Declaration of Helsinki. The study protocol was reviewed and approved by the Ethic Committee of the Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital (approval number: 201604142k21).


Consent to Participate Statement

All the patients' guardians gave their informed consent.


Author Contributions

C.X. and H.Z. conceived the study and designed the protocol. H.Z. selected the patients and extracted the relevant information. C.X. and W.H. wrote the first draft of the manuscript. T.Y. organized the data. All the authors critically revised successive drafts of the article and approved the final version. J.M., H.Z., and C.X. are the study guarantors. The corresponding author attests that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted.


Availability of Data and Materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


* These authors contributed equally to this work.




Publikationsverlauf

Eingereicht: 19. Juli 2023

Angenommen: 20. Dezember 2023

Accepted Manuscript online:
27. Dezember 2023

Artikel online veröffentlicht:
31. Mai 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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