ArticleNeurosurgical review2025
Comparing various surgical interventions versus conservative medical treatment in spontaneous supratentorial intracerebral hemorrhage: a network meta-analysis of the randomized controlled trials.
Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Optimized Endoscopic Hemostasis in Spontaneous Intracerebral Hemorrhage: A Pilot Study of the "Chopsticks" Technique.Neurosurgery practice · 2026Article
- Surgical management of intracerebral hemorrhage: A meta-analysis demonstrating improved functional outcome and survival with time-dependent functional benefit.Surgical neurology international · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spontaneous supratentorial intracerebral hemorrhage (SSICH) is a critical condition with a high risk of morbidity and mortality, often requiring prompt intervention. Various surgical approaches have been employed to enhance outcomes; however, their comparative effectiveness remains uncertain. Databases including PubMed, Cochrane Central, and ScienceDirect were searched from inception till February 2025 for Randomized controlled trials (RCTs) investigating neuroendoscopy (NE), stereotactic aspiration (SA), craniopuncture surgery (CP), craniotomy (CR), decompressive craniectomy (DC), and conservative medical treatment (CMT). A frequentist network meta-analysis was conducted using R version 4.2.1 and the "netmeta" package, employing the random effects model. Treatment ranking was performed using p-scores, and the risk of bias was assessed using the ROB 2.0 tool. Publication bias was evaluated visually through funnel plots and statistically through Egger's Regression test. The analysis included 25 RCTs involving 4,324 patients. Compared to CMT, NE (RR = 1.77, 95% CI: [1.43,2.20]; p < 0.0001), SA (RR = 1.65, 95%CI: [1.38,1.98]; p < 0.0001), and CR (RR = 1.26, 95%CI: [1.04,1.54]; p = 0.019) showed significant improvement in good functional outcome (GFO) and NE was ranked the best for functional improvement (p-score = 0.93). Mortality was significantly reduced in NE (RR = 0.67, 95%CI: [0.52,0.85]; p = 0.001), and CR (RR = 0.82, 95%CI: [0.69,0.98]; p = 0.028) compared to CMT. NE was considered the most optimal treatment for reducing mortality (p-score = 0.81). Compared to CMT, the risk of rebleeding and overall complications was not significantly different with the surgical interventions. NE, SA and CR significantly improved functional outcomes whereas NE and CR reduced mortality in patients with SSICH compared to CMT. NE may be the most optimal treatment for improving functional scores and mortality according to p-score ranking. Further, high-quality multicenter randomized clinical trials are required.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.