Endoscope-assisted techniques for evacuation of acute subdural haematoma in the elderly: The lesser of two evils? A scoping review of the literature

Spencer, Robert; Manivannan, Susruta; Zaben, Malik

doi:10.1016/j.clineuro.2021.106712

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…Multiple studies have arbitrarily set a minimum age as a selection criterion for suitability to undergo EASE. Spencer et al suggested an age >80 years old, 9 while Yokosuka et al accepted a lower age of >70 years old. 13 Brain atrophy evaluation using the GCA score may help decide the suitability of patients for EASE instead of relying on age as an arbitrary marker for cerebral atrophy.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion

Sam,

Komatsu,

Yamada

et al. 2024

Asian J Neurosurg

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Introduction Acute subdural hematomas (ASDHs) have a high mortality rate and unfavorable outcomes especially in the elderly population even after surgery is performed. The conventional recommended surgeries by the Brain Trauma Foundation in 2006 were craniotomies or craniectomies for ASDH. As the world population ages, and endoscopic techniques improve, endoscopic surgery should be utilized to improve the outcomes in elderly patients with ASDH. Materials and Methods This was a single-center retrospective report on our series of six patients that underwent endoscopic ASDH evacuation (EASE). Demographic data, the contralateral global cortical atrophy (GCA) score, evacuation rates, and outcomes were analyzed. Results All patients' symptoms and Glasgow Coma Scale improved or were similar after EASE with no complications. Good outcome was seen in 4 (66.7%) patients. Patients with poor outcome had initial low Glasgow Coma Scale scores on admission. The higher the contralateral GCA score, the higher the evacuation rate (r = 0.825, p ≤ 0.043). All the patients had a GCA score of ≥7. Conclusion EASE is at least not inferior to craniotomy for the elderly population in terms of functional outcome for now. Using the contralateral GCA score may help identify suitable patients for this technique instead of just using a cut-off age as a criteria.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion

Sam,

Komatsu,

Yamada

et al. 2024

Asian J Neurosurg

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“…ere have been increasing reports of the use of endoscopic hematoma evacuation for ASDH in the elderly. [1][2][3][4][5][7][8][9][10][11][12][13][14] In a recent scoping review, mortality rates ranged between 0% and 40%, whereas the rate of favorable outcomes ranged between 26.7% and 96.4%. [13] Rebleeding was the most commonly reported complication, with a prevalence ranging between 0% and 13%.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][7][8][9][10][11][12][13][14] In a recent scoping review, mortality rates ranged between 0% and 40%, whereas the rate of favorable outcomes ranged between 26.7% and 96.4%. [13] Rebleeding was the most commonly reported complication, with a prevalence ranging between 0% and 13%. [13] In this case series, the patients' mean age was 82.6 years, the mortality rate was 22.2%, and the proportion of patients with a favorable prognosis was 33.3%.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Rebleeding was the most commonly reported complication, with a prevalence ranging between 0% and 13%. [13] In this case series, the patients' mean age was 82.6 years, the mortality rate was 22.2%, and the proportion of patients with a favorable prognosis was 33.3%. e reported craniotomy size ranged between 2 and 5 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, reports on endoscopic hematoma removal with small craniotomy for ASDH have been increasing. [1][2][3][4][5][7][8][9][10][11][12][13][14] is minimally invasive surgery could compensate for the disadvantages of craniotomy and craniectomy. In this study, we report a case series of nine patients with ASDH who underwent endoscopic hematoma removal with small craniotomy under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic hematoma evacuation for acute subdural hematoma with improvement of the visibility of the subdural space and postoperative management using an intracranial pressure sensor

Tanaka

Goto

Momozaki

et al. 2023

Surgical Neurology International

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Background: The first choice to treat acute subdural hematoma (ASDH) is large craniotomy under general anesthesia. However, increasing age or the comorbid burden of patients may render invasive treatment strategy inappropriate. These medically frail patients with ASDH may benefit from a combination of small craniotomy and endoscopic hematoma removal, which is less invasive. We proposed covering with protective sheets to prevent brain injury due to contact with the endoscope and suction cannula and improve visualization of the subdural space. Moreover, we placed an intracranial pressure (ICP) sensor after endoscopic hematoma removal. In this article, we attempted to clarify the use of small craniotomy evacuation with endoscopy for ASDH. Methods: Between January 2015 and December 2019, nine patients with ASDH underwent hematoma evacuation with endoscopy at our hospital. ASDH was removed using a suction tube with the aid of a rigid endoscope through the small craniotomy (5–6 cm). Improvement of the clinical symptoms and procedure-related complications was evaluated. Results: No procedure-related hemorrhagic complications were observed. The outcomes of our endoscopic surgery were satisfactory without complications or rebleeding. The outcomes were not inferior to those of other reported endoscopic surgeries. Conclusion: The results suggest that small craniotomy evacuation with endoscopy and postoperative management using an ICP sensor is a safe, effective, and minimally invasive treatment approach for ASDH in appropriately selected cases.

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Subdural Hematomas in Adults and Children

Sağıroğlu

Turğut

2023

Advances and Technical Standards in Neurosurgery

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Endoscope-assisted techniques for evacuation of acute subdural haematoma in the elderly: The lesser of two evils? A scoping review of the literature

Cited by 8 publications

References 34 publications

Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion

Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion

Endoscopic hematoma evacuation for acute subdural hematoma with improvement of the visibility of the subdural space and postoperative management using an intracranial pressure sensor

Subdural Hematomas in Adults and Children

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