{
  "abstract": "Background The recently completed Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) trial demonstrated a benefit for endoport-mediated evacuation within ≤24 hours for lobar hemorrhages but not for basal ganglia hemorrhages (BGH). We performed an exploratory evaluation of the Stereotactic Cerebral Underwater Blood Aspiration (SCUBA) technique for BGH evacuation.Methods We reviewed data from patients presenting to an urban health system with BGH who underwent SCUBA evacuation according to institutional guidelines. Three cohorts were then created: (1) all patients with BGH evacuation using the SCUBA approach; (2) patients with BGH evacuation using SCUBA within ≤24 hours and with ENRICH-defined intraventricular hemorrhage (IVH) selection criteria; and (3) SCUBA evacuation within ≤24 hours, ENRICH-defined IVH, and intracerebral hemorrhage (ICH) volumes of ≥30 mL. Key outcomes included evacuation percentage, residual hematoma volume ≤15 mL, and 6-month modified Rankin Scale (mRS) score of 0–3.Results Sixty-eight patients with BGH underwent SCUBA. Median preoperative ICH volume was 35 mL and median postoperative volume was 1.3 mL for a median evacuation percentage of 97%, with 90% achieving ≤15 mL residual volume. For 19 patients in cohort 2 and 12 patients in cohort 3, median evacuation percentages were 98% and 100% of patients had ≤15 mL residual volume in both groups. A good outcome was achieved in 53% and 50% of patients, respectively.Conclusions SCUBA evacuation for BGH in patients who otherwise meet ENRICH criteria suggests superior 6-month outcomes compared with ENRICH BGH patients (utility-weighted mRS 0.51 vs 0.34). A randomized clinical trial is warranted to prospectively evaluate SCUBA evacuation within 24 hours in patients with spontaneous BGH.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Christopher Paul Kellner"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Muhammad Ali"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Roshini Kalagara"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Akhil Rao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Colton Smith"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Joshua Finesilver"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Trevor Hardigan"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Tomoyoshi Shigematsu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA",
        "Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "John Liang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA",
        "Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Fernanda Carvalho Poyraz"
    },
    {
      "affiliations": [
        "Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Michael F Waters"
    },
    {
      "affiliations": [
        "Stroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"
      ],
      "name": "Magdy Selim"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "J Mocco"
    }
  ],
  "title": "SCUBA evacuation within 24 hours of basal ganglia hemorrhage results in promising functional outcomes",
  "uid": "de0191f7-fe17-5c59-a1ff-38cca2add85f"
}