Impact of stereotactic hematoma evacuation on medical costs during the chronic period in patients with spontaneous putaminal hemorrhage: a randomized study

Surgical Neurology
Naoyuki HattoriAlexander Gatherer

Abstract

Stereotactic hematoma evacuation (SHE) has been reported to reduce mortality and to improve functional outcome in patients with spontaneous putaminal hemorrhage. Stereotactic hematoma evacuation has not been widely accepted, however, as a standard therapy because its effect on functional outcome has been regarded as marginal and insufficient to justify the costs of surgery. We reassessed the value of SHE by analyzing its impact on chronic-period medical costs based on an original randomized study carried out by us. In total, 490 patients were entered into the study. The degree of neurologic severity was defined on admission according to the neurologic grades (NGs) ranging from NG1 to NG5, adopted by the Japanese Cooperative Study on Stroke Surgery. The NG2 and 3 patients were randomized into 2 groups with different treatment protocols (group I, SHE; group II, conservative treatment). On the other hand, the NG1, 4, and 5 patients were excluded from the randomization because a large-scale retrospective study in Japan had revealed that surgical treatment in patients assigned to these NG grades does not improve functional outcome. Among the 490 patients, 248 were excluded and 242 were randomized strictly. The latter patients compri...Continue Reading

References

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Citations

Oct 29, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mahesh Ramanan, Aparna Shankar
Sep 13, 2013·The Journal of International Medical Research·Zhiping DunHao Jiang
Oct 10, 2013·British Journal of Hospital Medicine·Ahmed-Ramadan Sadek, C Andy Eynon
Apr 26, 2014·Journal of Cerebrovascular and Endovascular Neurosurgery·Youn Hyuk Chang, Sung-Kyun Hwang
Aug 31, 2018·Journal of Neurosurgical Sciences·Claudio CavalloPeter Nakaji
Mar 1, 2007·Current Opinion in Critical Care·A David Mendelow, Andreas Unterberg

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