Efficacy evaluation of the hard-channel technique and transsylvian microsurgical operation in the treatment of basal ganglia haemorrhage.

[OBJECTIVE] To compare the efficacy and safety of the hard-channel technique and the transsylvian microsurgical operation in treating basal ganglia cerebral haemorrhage (BGCH).

[METHODS] Clinical data from 100 patients with BGCH treated at our hospital between February 2019 and May 2022 were analysed. Patients were divided into two groups based on the surgical approach: the hard-channel group ( = 55) and the microsurgery group ( = 45). Intraoperative and postoperative outcomes were compared.

[RESULTS] The hard-channel group had a shorter surgery duration (32.37 ± 8.32 vs 197.14 ± 39.77 min,  < 0.001) and less intraoperative bleeding (3.59 ± 2.29 vs 247.62 ± 125.73 mL,  < 0.001) but a lower haematoma clearance rate (80.74% ± 13.19% vs 91.10% ± 6.47%,  < 0.001) than the microsurgery group. Postoperatively, the hard-channel group had a longer hospital stay (20.67 ± 11.96 vs 13.90 ± 4.65 days,  = 0.035), whereas no significant difference was observed in the incidence of complications ( = 0.079). The microsurgery group demonstrated better functional outcomes, with higher Glasgow Outcome Scale (GOS) and activities of daily living (ADL) scores at 1, 3 and 5 months as well as higher National Institutes of Health Stroke Scale scores at 1 and 3 months ( < 0.05).

[CONCLUSION] The hard-channel technique was found to offer a shorter surgery duration and reduced intraoperative bleeding. The transsylvian microsurgical approach was associated with higher GOS and ADL scores at earlier time points (1 and 3 months), suggesting a potentially faster recovery. However, these differences were not sustained at 5 months. These findings highlight the need for individualised treatment decisions based on patient-specific factors and further studies to validate these observations.