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

Abstract

Introduction: It remains controversial 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 between January 2012 and November 2016 were included in the study. Sixteen patients with frameless stereotactic surgical treatment (ST group) and twenty-three patients with conservative treatment (CT group). Clinical and radiological parameters were assessed, and 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 5-10 ml or GCS scores of 6-8, following treatment, the ST group exhibited markedly higher Glasgow Outcome Scale (GOS) scores in comparison to the CT group. Conclusion: In 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 5-10 ml or GCS scores of 6-8 could benefit from surgery.