Brain and behavior · 2026
Neuroendoscopy Versus External Ventricular Drainage for Thalamic Hemorrhagic Stroke: A Systematic Review and Bayesian Meta-Analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sikembi Pedro Tchicama, Vega-Medina Pablo Andrés, Batista Albe Dias, Amorim Davi Ricardo Soares Gama de, Godina-Sanchez Angel F, González-Chang Laura Alexandra
Аннотация
BACKGROUND: Neuroendoscopy and external ventricular drainage are commonly considered first-line options for managing thalamic hemorrhage. However, their effectiveness in reducing the risk of rebleeding remains unclear.
AIM: To compare the efficacy and safety of neuroendoscopy versus external ventricular drainage through a systematic review and Bayesian meta-analysis of randomized and nonrandomized studies.
METHODS: We searched PubMed, Embase, and Cochrane for randomized and nonrandomized studies comparing neuroendoscopy with external ventricular drainage in patients with spontaneous thalamic hemorrhage. Data analysis was conducted using a Bayesian random-effects model, with 95% credible intervals (CrI), estimating risk ratios for binary endpoints and mean differences for continuous endpoints.
RESULTS: Six studies comprising 399 patients were included in the meta-analysis. Although the pooled analysis showed no significant difference between groups in rebleeding risk (RR 0.61, 95% CrI 0.26-1.46; I2 = 20.3%), neuroendoscopy was associated with an 87.4% posterior probability of reducing rebleeding risk compared with external ventricular drainage. Notably, neuroendoscopy significantly reduced the need for ventriculoperitoneal shunt (RR 0.48, 95% CrI 0.25-0.91; I2 = 23.4%), with a 98.6% posterior probability of benefit. It was also associated with favorable prognosis (RR 1.42, 95% CrI 1.05-1.94, I2 = 17%), with a 98.84% posterior probability of benefit.
CONCLUSION: In patients with thalamic hemorrhage, neuroendoscopy was associated with a higher probability of reducing both rebleeding risk and the need for ventriculoperitoneal shunt compared with external ventricular drainage.
AIM: To compare the efficacy and safety of neuroendoscopy versus external ventricular drainage through a systematic review and Bayesian meta-analysis of randomized and nonrandomized studies.
METHODS: We searched PubMed, Embase, and Cochrane for randomized and nonrandomized studies comparing neuroendoscopy with external ventricular drainage in patients with spontaneous thalamic hemorrhage. Data analysis was conducted using a Bayesian random-effects model, with 95% credible intervals (CrI), estimating risk ratios for binary endpoints and mean differences for continuous endpoints.
RESULTS: Six studies comprising 399 patients were included in the meta-analysis. Although the pooled analysis showed no significant difference between groups in rebleeding risk (RR 0.61, 95% CrI 0.26-1.46; I2 = 20.3%), neuroendoscopy was associated with an 87.4% posterior probability of reducing rebleeding risk compared with external ventricular drainage. Notably, neuroendoscopy significantly reduced the need for ventriculoperitoneal shunt (RR 0.48, 95% CrI 0.25-0.91; I2 = 23.4%), with a 98.6% posterior probability of benefit. It was also associated with favorable prognosis (RR 1.42, 95% CrI 1.05-1.94, I2 = 17%), with a 98.84% posterior probability of benefit.
CONCLUSION: In patients with thalamic hemorrhage, neuroendoscopy was associated with a higher probability of reducing both rebleeding risk and the need for ventriculoperitoneal shunt compared with external ventricular drainage.