Minimally invasive puncture versus conventional craniotomy for spontaneous supratentorial hemorrhage: A meta-analysis

Neurochirurgie. 2021 Jul;67(4):375-382. doi: 10.1016/j.neuchi.2020.11.004. Epub 2020 Nov 23.


Background: Minimally invasive puncture and conventional craniotomy are both utilized in the treatment of spontaneous supratentorial hemorrhage. The purpose of this study is to review evidence that compares the safety and effectiveness of these two techniques.

Methods: We searched EMBASE, Cochrane Library, Web of Science, and PubMed for studies published between 2000 and 2019 that compared the minimally invasive puncture procedure with the conventional craniotomy for the treatment of spontaneous supratentorial hemorrhage.

Results: Seven trials (2 randomized control trials and 5 observational studies) with a total of 970 patients were included. The odds ratio indicated a statistically significant difference between the minimally invasive puncture and conventional craniotomy in terms of good functional outcome (OR 2.36, 90% CI 1.24-4.49). The minimally invasive puncture procedure was associated with lower mortality rates (OR 0.61, 90% CI 0.44-0.85) and rebleeding rates (OR 0.48, 95%CI 0.24-0.99; P=0.003).

Conclusions: The use of the minimally invasive puncture for the management of spontaneous supratentorial hemorrhage was associated with better functional outcome results, a lower mortality rate, and decreased rebleeding rates. However, because insufficient data has been published thus far, we need more robust evidence to provide a better guide for future management.

Keywords: Conventional craniotomy; Meta-analysis; Minimally invasive puncture; Spontaneous supratentorial hemorrhage.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / surgery*
  • Craniotomy / methods*
  • Craniotomy / mortality
  • Craniotomy / trends
  • Humans
  • Minimally Invasive Surgical Procedures / methods*
  • Minimally Invasive Surgical Procedures / mortality
  • Minimally Invasive Surgical Procedures / trends
  • Observational Studies as Topic / methods
  • Punctures / methods*
  • Punctures / mortality
  • Punctures / trends
  • Randomized Controlled Trials as Topic / methods
  • Treatment Outcome