title: Stereotactic aspiration plus subsequent thrombolysis for moderate thalamic hemorrhage.
abstract: OBJECTIVE
  This study aimed to evaluate the efficacy and safety of stereotactic aspiration combined with subsequent thrombolysis in treating moderate thalamic hemorrhage (TH).
  
  
  METHODS
  A total of 105 patients with TH were nonrandomly assigned to the conservative treatment group (n = 60) or to the aspiration group (n = 45). Patients in the aspiration group were treated with stereotactic aspiration plus subsequent thrombolysis for removal for their hematomas.
  
  
  RESULTS
  The 30-day mortality in the conservative group was significantly higher than that in the aspiration group (28.3% (17/60) vs. 11.2% (5/45), P = 0.032). The rank of the 30-day Glasgow outcome scale in the conservative group was significantly lower than that in the aspiration group (P = 0.041), and the mean 30-day National Institutes of Health Stroke Scale score of the survivors in the conservative group was significantly higher than that in the aspiration group (16.5 ± 4. 2 vs. 14.2 ± 3.9, P = 0.012). There were a greater reduction in TH volume in the aspiration group than in the conservative group from day 1 to day 3 (-0.24% and 39.28%, respectively, P < 0.0001) and from day 1 to day 7 (26.58% and 63.26%, respectively, P < 0.0001). The rank of 90-day Glasgow outcome scale was significantly lower in the conservative group than that in the aspiration group (P = 0.015). Eighteen of 60 patients (30.0%) had a favorable outcome in the conservative group, whereas 23 of 45 patients (51.1%) had a favorable outcome in the aspiration group, and this difference was significant (P = 0.028). The 90-day cumulative mortality rate in the conservative group was significantly higher than that in the aspiration group (33.3% (20/60)) vs. 15.6% (7/45), P = 0.039).
  
  
  CONCLUSIONS
  Stereotactic aspiration plus subsequent thrombolysis is effective and safe for moderate TH.
authors: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, People's Republic of China.
authors: Maogang
authors: M
authors: Chen
authors: Qizhang
authors: Q
authors: Wang
authors: Wusheng
authors: W
authors: Zhu
authors: Qin
authors: Q
authors: Yin
authors: Minmin
authors: M
authors: Ma
authors: Xinying
authors: X
authors: Fan
authors: Yongkun
authors: Y
authors: Li
authors: Guanzhong
authors: G
authors: Ni
authors: Chaolai
authors: C
authors: Liu
authors: Wenhua
authors: W
authors: Liu
authors: Renliang
authors: R
authors: Zhang
authors: Gelin
authors: G
authors: Xu
authors: Xinfeng
authors: X
authors: Liu
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D020300:Intracranial Hemorrhages / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D013238:Stereotaxic Techniques; D013396:Suction / Q000379:methods*; D013786:Thalamic Diseases / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator