1380 Basal Ganglia Hemorrhage Evacuation Using the SCUBA Technique Results in Excellent Evacuation Rates

INTRODUCTION: Spontaneous intracerebral hemorrhage (ICH) is the most debilitating form of stroke with only 20% of patients reaching independence 6 months after the event. Endoscopic evacuation performed with the Stereotactic Intracerebral Hemorrhage Underwater Blood Aspiration (SCUBA) technique evacuation utilizes a small access profile, excellent intracavitary visibility, and the ability to wash the hemorrhage cavity with irrigation to improve endoport-mediated hemorrhage evacuations. METHODS: Patients with spontanous basal ganglia ICH, age = 18, premorbid mRS = 3, hematoma volume = 15mL, and presenting NIHSS score = 6 who underwent SCUBA were included in this study. RESULTS: 70 patients with basal ganglia ICH underwent evacuation with SCUBA. The average age was 57±13 years. The median preoperative volume was 36mL[23-50]. The median time from ictus to evacuation was 27[13-54] hours and the median SCUBA time was 1.6[1.2-2.3] hours. The median post-operative volume was 1mL [0-6] for a median evacuation percentage of 96% [87-99]. The median postoperative mGS among patients co-presenting with IVH was 7 [2-12] (vs. paired preoperative mGS p<0.0001). The median hospital LOS was 18 days [IQR: 9-27] and the median ICU LOS was 9 days [IQR: 4-17]. Most patients were discharged to acute rehabilitation (51%). Thirty-day mortality for the entire cohort was 7%. The median 6-month mRS was 4 [3-5]. 21 (32%) patients achieved a good 6-month functional outcome. These patients were younger (52 vs. 61, p=0.005), less debilitated on presentation (NIHSS 16 vs. 21, p=0.0004), less likely to co-present with IVH (10% vs 41%, p=0.01), with lower preoperative hematoma volumes (27mL vs. 38mL, p=0.01) and lower postoperative residual hematoma volumes (0.6mL vs. 2.5mL, p=0.05) CONCLUSIONS: The SCUBA technique may provide advantages over endoport-mediated evacuation, particularly in the case of basal ganglia hemorrhages.