Outcomes between endoscopic-assisted minimally invasive surgery and conventional craniotomy in spontaneous intracerebral hemorrhage

The purpose of this retrospective study was to compare the outcomes of endoscopic surgery and conventional craniotomy for treating spontaneous intracerebral hemorrhage (ICH). The medical records of patients with spontaneous ICH who underwent surgery at our center from 2018 to 2024 were retrospectively reviewed. Patients were divided into those who received endoscopic surgery and those who received conventional craniotomy. Outcomes were in-hospital mortality and modified Rankin scale (mRS) score at discharge. A total of 99 patients were included in the study, of which 49 received endoscopic surgery and 50 received craniotomy. The median age of the patients was 64.0 years, and 62% were male. Patients in the endoscopic surgery group were significantly older (68.0 vs. 62.0 years, p = 0.010), and had higher frequencies of low Glasgow coma scale scores (3–5, 6% vs. 2.0%; 6–12, 78% vs. 56%, p = 0.010), intraventricular hemorrhage (73% vs. 42.0%, p = 0.002), and high ICH score (3–4, 65% vs. 36%, p = 0.004). No significant differences in in-hospital mortality (20% vs. 28%, p = 0.378) and mRS at discharge (0–3, 35% vs. 28%; 4–6, 65% vs. 72%; p = 0.473) were observed between the 2 groups. In conclusion, the results showed no significant differences in in-hospital mortality and mRS score at discharge between patients who underwent endoscopic surgery or craniotomy for an ICH. Future prospective studies are still warranted to further evaluate the potential benefits of endoscopic surgery, particularly in patients with more severe initial presentations.