Objective:

To compare treatment efficacy for severe hypertensive pontine hemorrhage (HPH) and identify prognostic factors to guide clinical decisions.

Approach:

Key Findings:

• Surgical group had significantly lower 30/90-day mortality and 90-day unfavorable functional outcomes compared to the pharmacological group (P < 0.05).
• No significant difference in 30-day unfavorable functional outcomes between groups (P = 0.087).
• Craniotomy achieved higher hematoma clearance but increased intracranial infection risk; stereotactic drainage offered shorter ICU/hospital stays but higher rebleeding risk.
• Independent adverse prognostic factors included older age, lower GCS score, larger hematoma volume, acute obstructive hydrocephalus, and massive hematoma morphology.

Interpretation:

Surgery is associated with reduced mortality and unfavorable functional outcomes in severe HPH, with distinct safety-efficacy profiles for stereotactic drainage and craniotomy that should inform clinical decisions.

Limitations:

• This is a retrospective single-center study, limiting the ability to establish definitive causality and introducing potential biases.
• Results should be interpreted cautiously; larger multi-center prospective trials are needed for validation.

Conclusion:

Surgery correlates with significantly reduced mortality and unfavorable outcomes in severe HPH, but findings do not constitute formal treatment recommendations.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.