A new clinical trial has shown that a less invasive type of brain surgery may be a safe and helpful option for people who suffer from the most dangerous type of stroke—an intracerebral hemorrhage.
The results, published in the journal JAMA Neurology, are giving doctors new hope for treating this severe condition.
An intracerebral hemorrhage happens when a blood vessel bursts and bleeding occurs inside the brain.
This kind of stroke makes up about 15% of all strokes but has the highest death rate.
It can cause severe damage by increasing pressure in the brain and harming nearby brain tissue. So far, surgical options to treat it have been very limited and risky.
Traditionally, surgeons have needed to open up a large part of the skull and cut into the brain to remove the blood clot.
While this approach can save lives, it doesn’t always help patients recover their ability to move, think clearly, or take care of themselves afterward.
The new study, led by researchers at Northwestern Medicine and other institutions around the world, tested a newer and gentler approach called minimally invasive endoscopic surgery. Instead of removing a large section of the skull, surgeons drilled a small hole no bigger than a dime.
Using computer guidance, they inserted a tiny camera and surgical tools through the hole and carefully removed the blood clot without damaging surrounding brain tissue.
The trial involved 236 patients from 32 hospitals around the world who had suffered spontaneous bleeding in the upper part of the brain.
The patients were randomly assigned to two groups: one group received the new surgery within 72 hours of their stroke, along with regular medical care; the other group only received medical care.
Patients ranged in age, but the average age was 60. About one-third were female, and two-thirds had bleeding in deeper brain tissue, while the rest had bleeding in the brain’s outer lobes.
The researchers found that the surgery did not significantly reduce the number of deaths 30 days after the procedure or improve long-term disability at 180 days compared to medical treatment alone. However, patients who had the surgery did show better recovery at 30 days and fewer serious health complications at 180 days.
Dr. Babak Jahromi, a lead researcher on the study, said that while the long-term benefits still need to be explored, the surgery clearly helped patients recover more quickly in the early stages. This is a big deal because faster recovery means patients can leave intensive care units sooner and may have a better chance at rehabilitation.
He also pointed out that this is the first time a large study has shown that endoscopic surgery for this type of stroke is not only safe but also shows some early benefits. Future research will look at which patients benefit the most from the procedure and when is the best time to perform it.
Jahromi compared this strategy to how doctors treat high blood pressure—using a combination of approaches to manage a complex problem. Similarly, a mix of early surgery and medical care might be the key to helping more people survive and recover after a brain bleed.
While more studies are needed, this trial represents an important step forward in treating hemorrhagic strokes. For many patients, this could mean a safer surgery option and a better shot at recovery.
If you care about stroke, please read studies that Thanks to his wife’s quick reaction, postal worker fully recovered from a stroke and new hope for people with irregular heartbeat to prevent stroke.
For more health information, please read studies that Stronger high blood pressure treatment may help prevent stroke in older people and Stroke death risk increases again after falling for 40 years.
The study is published in JAMA Neurology.
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