Introduction: Choosing between hematoma catheterization and medical treatment is controversial in cases of borderline basal ganglia hematoma volume. The purpose of this study was to evaluate the benefits of FNSC in patients with borderline spontaneous basal ganglia hematoma volume without intraventricular hemorrhage (IVH) extension.

Methods: Medical records from 238 patients who were diagnosed with spontaneous intracerebral hematoma (ICH) at our institution between January 2008 and December 2012 were reviewed. Sixty-three patients met inclusion criteria and were divided into two groups; the conservative medical treatment group (group A, n=29) and the catheterization group (group B, n=34). Borderline hematoma volume was defined as 20 to 50? measured with computed tomography (CT). FNSC was performed within 24 hours post-ictus. Modified Rankin Scale (mRS), recovery of motor weakness, period in intensive care unit (ICU), and total hospitalization period (HP) were compared between the two groups.

Results: Group B showed earlier recovery of motor weakness and improvement of mRS compared to group A (p < 0.001 and 0.001, respectively). Final mRS at 12 months was more favorable in group B (p=0.006). Both period in ICU and total HP were shorter in group B than in group A (p = 0.001 and p = 0.006, respectively). Predisposing factors for good outcome were hematoma volume less than 30? (p = 0.028), initial Glasgow coma scale (GCS) score of =13 (p = 0.036), and absence of internal capsule involvement (p = 0.031). A regression analysis showed frameless navigation-guided stereotactic catheterization had a significant effect on favorable outcome (p = 0.003).

Conclusions: FNSC may have beneficial effects on total hospitalization period, ICU period, early recovery of motor weakness, and functional status in patients with borderline basal ganglia hematoma volume without IVH, especially in patients who had good initial GCS score, hematoma volume of 20 to 30 mL, and no internal capsule involvement.

Patient Care: By the conculsion of our study, minimally invasive hematoma evacuation of basal ganglia hemorrhage may be improve functional outcomes in selective patients.

Learning Objectives: By the conclsuin of this session, participants should bo able to identify an effective treatment of small amount basal ganglia hemorrhage

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