Neuroendoscopy Versus External Ventricular Drainage for Thalamic Hemorrhagic Stroke: A Systematic Review and Bayesian Meta-Analysis.

Authors

Pedro Tchicama Sikembi, Pablo Andrés Vega-Medina, Albe Dias Batista, Davi Ricardo Soares Gama de Amorim, Angel F Godina-Sanchez, Laura Alexandra González-Chang

Published in

Brain and behavior. Volume 16. Issue 6. Pages e71526.

Abstract

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.
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.
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.
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.
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.

PMID:
42324583
Bibliographic data and abstract were imported from PubMed on 22 Jun 2026.

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