Efficacy of robotic-assisted stereotactic puncture and drainage for primary brainstem hemorrhage

ZHANG Ning; YU Guoyuan; LI Xinhao; WANG Xiwang; ZHU Xu

doi:10.13798/j.issn.1009-153X.2026.01.003

Abstract：Objective To investigate the clinical efficacy of robotic-assisted stereotactic puncture and drainage for pri-mary brainstem hemorrhage.Methods A retrospective analysis was performed on the clinical data of six patients with primary brainstem hemorrhage treated with robotic-assisted stereotactic puncture and drainage in the Second Department of Neurosurgery at Handan Central Hospital from September 1,2023,to December 31,2023.Results The GCS scores on admission ranged from 3 to 8(mean,5.0±1.8).The hematoma volume ranged from 7.8 to 15.0 mL(mean,10.2±2.7 mL).All hemorrhages were located in the pons,including four transverse hemorrhages and two unilateral hemorrhages.The robotic registration error ranged from 0.48 to 1.2 mm(mean,0.69±0.29 mm).No puncture tract hemorrhage occurred postoperatively.Dynamic head CT scans were performed postoperatively.One patient experienced rebleeding at 48 hours postoperatively,did not respond to resuscitation and died.Com-plete hematoma resolution was observed in one patient at 2 days,one at 3 days,one at 4 days,one at 8 days,and one at 12 days postoperatively.Within the first postoperative month,complications included one case of intracranial infection,one case of severe pneumonia,two cases of stress ulcer,and one case of refractory hyponatremia.One patient required postoperative ventilatory sup-port.At the 90-day follow-up,two patients(33.3%)had died.Among the four survivors,the GOS scores were 5 in two patients(33.3%),3 in one patient,and 2 in one patient.Conclusion Robotic-assisted stereotactic puncture and drainage demonstrates definite clinical efficacy in the treatment of primary brainstem hemorrhage,offering advantages such as precision,safety,minimal collateral damage,and rapid effective hematoma evacuation.