Comparative analysis of stereotactic soft-channel and hard-channel aspiration in the treatment of primary brainstem hemorrhage.

Objective: To evaluate the efficacy of stereotactic soft-channel and hard-channel aspiration in the treatment of primary brainstem hemorrhage.

Methods: The clinical data of 146 patients with primary brainstem hemorrhage at the First Hospital of Hebei Medical University from August 2014 to August 2023 were analyzed. At admission, 146 patients were divided into soft-channel group or hard-channel group using a random number table method. Sixty-five patients were treated with stereotactic soft-channel aspiration, and 81 patients were treated with stereotactic hard-channel aspiration. The amount of residual hematoma was evaluated by head CT immediately after the operation, and the length of the indwelling drainage tube was recorded. Survival status at 30d after the operation and treatment outcome (mRS score and GOS score) at 90d after the operation were also recorded. The amount of residual hematoma immediately after the operation, the length of the indwelling drainage tube after the operation, the mortality rate and the treatment outcome were compared between the two groups.

Results: There was significant difference in the mortality rate 30d after the operation (41.5% vs. 14.8%, χ = 20.192, P = 0.035) between stereotactic soft-channel aspiration and stereotactic hard-channel aspiration for brainstem hemorrhage. The hard-channel group had a higher survival rate. There was significant difference in the treatment outcome at 90 days after treatment (18.5% vs. 32.1%, χ = 4.783, P = 0.047). The hard-channel group showed better treatment outcomes 90 days after surgery.

Conclusion: Stereotactic hard-channel aspiration for primary brainstem hemorrhage has greater clearance efficiency than soft-channel aspiration and can significantly reduce patient mortality and improve treatment outcomes. Stereotactic hard-channel aspiration is a safe and effective method for treating primary brainstem hemorrhage.