Endoscopic evacuation of hypertensive putaminal hemorrhage guided by the 3D reconstructed CT scan: A preliminary report

Lo, Yu Chien; Liu, Yu Fang; Cho, Der Yang

doi:10.1016/j.clineuro.2010.08.006

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Lin et al used threedimensional reconstruction CT images combined with neuroendoscopy to locate HICH (HPH), which can accurately and effectively remove intracerebral hematoma. 12 Ding et al used microinvasive anterior cranial approach microsurgery to remove the massive basal ganglia blood. Through the nonframe stereotactic neuronavigation technique, an inner diameter that runs through the long axis of the hematoma is planned and craniotomy is made to improve the orbital zygomatic skull base on the upper margin of the right eyebrow and successfully remove the putamen hematoma.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Gong

2019

J Neurol Surg B Skull Base

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Background Hypertensive intracerebral hemorrhage is one of the most common cerebrovascular diseases with high mortality and high disability rate. The aim of this study was to observe the curative effect of minimally invasive liquefaction and drainage of hypertensive putaminal hemorrhage (HPH) through frontal approach. Methods This study retrospectively reviewed the clinical data of 66 HPH patients who underwent surgery from January 2012 to January 2017 including 35 males and 31 females, aged 51 to 82 years, with an average age of 61.6 ± 7.32 years. All patients were treated in the first people’s hospital of Kunshan. They were divided into two groups: puncture thrombolysis and drainage therapy (PTDT) group and conventional craniotomy (CC) group. Result The pulmonary infection rate in PTDT group was 13.8%, significantly lower than that of 27.7% in CC group (p < 0.05). One year after onset, the modified Rankin scale (mRS) score of surviving patients was evaluated. The mRS score of the PTDT group with 30 to 60 mL of preoperative bleeding was 1.91 ± 0.82, which was significantly better than that of the CC group (2.21 ± 0.83) (p < 0.05). There was no significant difference in mRS score between PTDT group (2.59 ± 0.62) and CC group (2.88 ± 0.87) with preoperative bleeding > 60 mL (p > 0.05). In patients with Glasgow coma scale (GCS) 5 to 8 scores, the mRS of PTDT and CC groups were 2.73 ± 0.72 and 2.94 ± 0.96, respectively (p > 0.05). In patients with GCS 9 to 13 scores, the mRS score of PTDT group was 1.83 ± 0.69, which was significantly better than that of CC group (2.06 ± 0.74) (p < 0.05). Conclusion HPH can be treated effectively through PTDT. PTDT group has lower lung infection rate than CC group. And it can significantly improve the prognosis of patients with preoperative bleeding volume of 30 to 60 mL and preoperative GCS score of 9 to 13.

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Section: Discussionmentioning

confidence: 99%

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Gong

2019

J Neurol Surg B Skull Base

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“…In 2010 [ 1 ] was described a similar technique to the one used in this report. The author used a 3D reconstructed CT scan to guide the entry point, depth of penetrating path and surgical trajectory.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic-assisted removal of traumatic brain hemorrhage: case report and technical note

et al. 2015

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The endoscopic technique has been described as a minimally invasive method for spontaneous hematoma evacuation, as a safe and effective treatment. Nevertheless, to our knowledge, there is no description of a technical report of traumatic intracerebral hematoma removal using the neuroendoscope. A 47-year-old man was admitted sustaining 13 points in Glasgow coma scale with brain computed tomography (CT) scan showing a temporal contusion. Guided by a 3D reconstructed CT, using the program OsiriX®, the posterior limit of the hematoma was identified. A burr hole was placed at the posterior temporal region, and we used the neuroendoscope to assist the hematoma evacuation. The postoperative tomography showed adequate hematoma removal. He was discharged from hospital 48 h after surgery. Two weeks later, he was conscious and oriented temporally. This endoscopic-assisted technique can provide safe removal of traumatic hematomas of the temporal lobe.

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“…On admission, the median GCS score for the patients was 9 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15], and median mRS scores were 4 (range, 2-5).…”

Section: Outcomes and Statistical Analysismentioning

confidence: 99%

“…Endoscopy is minimally invasive to the brain tissue, but it has some limitations. Trephination use in endoscopic surgery may damage the underlying brain tissue, such as the speech center on the left hemisphere, which may cause further neurological deficits or significant vessel injuries [12]. Further research is needed to overcome the shortcomings of limited visualization and limited working channels [19,20].…”

Section: Clinical Researchmentioning

confidence: 99%

“…However, obtaining adequate imaging data is sometimes difficult in patients with a significant volume of HICH, as they may not be cooperative during CT scanning, and the plane formed by the bilateral OM lines cannot always be accessed correctly on conventional CT images. In these situations, significant errors may result from approximate radiological or surgical planning without the use of stereotactic techniques or frameless navigating systems [12].…”

Section: Introductionmentioning

confidence: 99%

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Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages

Zhang

Chen

2019

Med Sci Monit

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Background:This case series study evaluated the outcome and effect of portable 3D-head computed tomography (CT, MCT-I, 16 rows mobile CT made in China) navigation-guided key-hole microsurgery for supratentorial hypertensive hematomas. Material/Methods:Thirty-five consecutive unconscious patients with a significant volume of hypertensive intracranial hemorrhages (HICH) were treated with 3D image-guided key-hole microsurgery, and the clinical features were summarized. Preoperative and postoperative hematoma volumes and reduction in midline shifts were calculated and recorded. The preoperative and postoperative (initial, discharge, and 180 th day after stroke onset) neurological status was assessed by Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS), and modified Rankin Scale (mRS) score, respectively. Results:The range of hematoma volumes of surgical patients was 24-99 ml (median, 50 ml). The median time of CT scan (from the time of the request to navigation finish) was 11 min. Total and near-total (>90%) hematoma evacuation was achieved in 96.9% cases. Compared with the initial state of neurological assessment, there was a significant improvement in MRS and GCS at discharge (P<0.001). After 6 months, 57.1% of patients had achieved functional recovery (GOS 4-5) and 2 patients had died. Conclusions:As a minimally invasive technique, image-guided transcortical sulci or transsylvian approach is highly effective for immediate and complete hematoma evacuation.

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Endoscopic evacuation of hypertensive putaminal hemorrhage guided by the 3D reconstructed CT scan: A preliminary report

Cited by 7 publications

References 18 publications

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Endoscopic-assisted removal of traumatic brain hemorrhage: case report and technical note

Portable 3D-Head Computed Tomography (CT) Navigation-Guided Key-Hole Microsurgery for Spontaneous Hypertensive Hemorrhages

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