Endoscopic-assisted evacuation of subdural collections

Mobbs, Ralph J.; Khong, Peter

doi:10.1016/j.jocn.2008.06.023

Cited by 47 publications

(45 citation statements)

References 13 publications

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“…4,13 Recently, minimally invasive surgery with a rigid or flexible endoscope for chronic SDH has been successfully demonstrated. 2,3,9,11,14 In a few previous reports bur hole surgery was performed for subacute SDH, with good outcomes. 5,6,16 Yamada et al reported on 20 patients in whom subacute SDH was treated with bur hole surgery.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Yokosuka

Uno

Matsumura

et al. 2015

JNS

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abbreviatioNs GCS = Glasgow Coma Scale; mRS = modified Rankin Scale; SDH = subdural hematoma. subMitted April 30, 2014. accepted October 17, 2014. iNclude wheN citiNg Published online April 24, 2015; DOI: 10.3171/2014.10.JNS14915. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patientsKimihiko Yokosuka, Md, phd, Masaaki uno, Md, phd, Kohei Matsumura, Md, hiroki takai, Md, hirotaka hagino, Md, Nobuhisa Matsushita, Md, phd, hiroyuki toi, Md, and shunji Matsubara, Md, phd Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan obJect Endoscopic surgery was performed for acute or subacute subdural hematoma (SDH), and its effectiveness and safety in elderly patients were evaluated. Methods Between September 2007 and November 2013, endoscopic surgery was performed in 11 elderly patients with acute SDH (8 patients) and subacute SDH (3 patients). The criteria for surgery were as follows: 1) the presence of clinical symptoms; 2) age older than 70 years; 3) no brain injury (intracerebral hematoma, brain contusion); 4) absence of an enlarging SDH; and 5) no high risk of bleeding. Hematoma evacuation was performed with a 4-mm rigid endoscope with a 0° lens and a malleable irrigation suction cannula. results Endoscopic surgery was performed under local anesthesia. The mean age of the patients was 82.6 years (range 73-91 years). There were 5 female and 6 male patients. The mean preoperative Glasgow Coma Scale score was 12, and 5 patients had been receiving antithrombotic drug therapy. The mean operation time was 85 minutes. Only 1 patient had rebleeding, and reoperation with the same technique was performed uneventfully in this individual. A total of 7 patients had a good recovery (modified Rankin Scale Score 0-2) at discharge. coNclusioNs Endoscopic hematoma evacuation of acute and subacute SDH is a safe and effective method of clot removal that minimizes operative complications. This technique may be a less invasive method for treating elderly patients with acute and subacute SDHs.

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Section: Discussionmentioning

confidence: 99%

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Yokosuka

Uno

Matsumura

et al. 2015

JNS

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“…Treating non-septated chronic SDHs can be easy with burrhole evacuation and washout (8). Sometimes treating the septated form of SDH can be more difficult with high rate of recurrence because of poor washout and division of neomembranes (8).…”

Section: █ Resultsmentioning

confidence: 99%

“…First drainage of the haematoma was performed using the standard method and the subdural space was irrigated with warm Ringer's lactate solution (8). The subdural space washed out with water until it was clean.…”

Section: A B C Dmentioning

confidence: 99%

“…T wist drill craniostomy, burr-hole craniostomy, and minicraniotomy or craniotomy are major methods to locate chronic subdural haematoma (SDH) (8). All of them have different morbidity, mortality, recurrence and cure rates (8,16).…”

Section: █ Introductionmentioning

confidence: 99%

“…All of them have different morbidity, mortality, recurrence and cure rates (8,16). Twist drill and burr-hole craniostomy are the first line surgical techniques, though craniotomy is usually preferred as a second line method (8).…”

Section: █ Introductionmentioning

confidence: 99%

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Evacuation of subdural collections by endoscopy

Boyaci

Gumustas²,

Korkmaz³

et al. 2015

Turkish Neurosurgery

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Our aim was to explore the theory that minimally invasive inspection of haematoma cavities is conceivable and might conceivably improve the remedial mediation of burr-hole drainage in chronic SDH. endoscope-assisted drainage technique with mini-craniotomy was used in a 24-month period, and the prospectively collected data of 8 patients was reviewed. █ mATERIAl and mEThODSOver 24 months, total of 10 procedures (8 patients) were performed with mini-craniotomy and endoscopic assistance. The indications for mini-craniotomy surgery are beyond the scope of this article. Six patients had one operation and they were operated on one side, and two patients had two operations and they were operated on at different times and sides. Consent was obtained from the patients. █ INTRODUCTION T wist drill craniostomy, burr-hole craniostomy, and minicraniotomy or craniotomy are major methods to locate chronic subdural haematoma (SDH) (8). All of them have different morbidity, mortality, recurrence and cure rates (8,16). Twist drill and burr-hole craniostomy are the first line surgical techniques, though craniotomy is usually preferred as a second line method (8).During the past 20 years, the general postoperative result of surgical treatment for chronic SDH has not enhanced considerably (2). Present studies only focus on the use of endoscopy for the evacuation of SDH. The use of intracranial endoscopy in neurotraumatology was initially considered as a specialized technique in 1980s (6).AIm: Intraoperative use of the endoscope is a hot topic in neurosurgery and it gives broader visualization of critical and hardlyreached areas. endoscope-assisted surgical approach to chronic subdural haematoma (SDH) is a minimally invasive technique and may give an expansion to the regular method of burr-hole haematoma drainage. mATERIAl and mEThODS: endoscope-assisted haematoma drainage with mini-craniotomy was performed over a 24-month period, and prospectively collected data is reviewed. A total of 10 procedures (8 patients) were performed using the endoscopeassisted technique. Four of them were chronic SDH and six were subacute SDH. RESUlTS:Procedures were extended 20 minutes in average because of endoscopic intervention. There was no extra-morbidity through the study as a consequence of endoscopic assessment.CONClUSION: endoscope-assisted techniques can make the operation safe in selected circumstances with improved intraoperative visualization. It may likewise take into consideration the identification and destruction of neo-membranes, septums and solid clots. In addition, the source of bleeding can be easily coagulated. The endoscope-assisted techniques, with all of these features, can alter the pre-and intra-operative decision-making for selected patients.

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