Three-dimensional reconstructed CT scanning for targeting hypertensive putaminal hemorrhage

Lo, Yu Chien; Chen, Chun-Chung; Chiou, Shang Ming; Lee, Han Chung; Huang, Heng; Cho, Der Yang

doi:10.1016/j.jocn.2007.05.027

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…Currently, accurate localization is generally based on image guidance or real-time ultrasound guidance 5,9,10,14 . CT-image-guided evacuation of intracerebral hemorrhage was widely used 15,16 . Many medical centers routinely adopted framed or frameless navigation systems.…”

Section: Discussionmentioning

confidence: 99%

3D-printed model-guided endoscopic evacuation for basal ganglia hemorrhage

Zhang¹,

Cheng

Zhou

et al. 2020

Sci Rep

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The purpose of this study was to investigate the effectiveness and practicality of 3D-printed modelguided endoscopic surgery for the treatment of basal ganglia hemorrhage. The authors retrospectively analyzed the data of all patients who underwent endoscopic evacuation of basal ganglia hemorrhage in the Department of Neurosurgery at Dalang Hospital and Shipai Hospital between December 2017 and February 2019. Twelve patients, in whom the 3D-printed model guidance was used for endoscopic evacuation, were included in this investigation. Using 3D reconstructed technology, we designed the appropriate surgical approach. Then, an individualized facial model with the guide orifice was printed by a 3D printer. Further, the 3D-printed model was employed to guide the insertion of the endoscope sheath. As a result, the average evacuation rate was 97.2% (range 90.1-100.0%). The GCS and mRS score were improved in each patient from admission to discharge examination. All patients had a good prognosis based on their functional independence measure (FIM) scores at the 6-month follow-up. The 3D-printed model-guided endoscopic evacuation was effective and safe for basal ganglia hemorrhage. This technique deserves further investigation to determine its role in intracerebral hemorrhage management. Hypertensive intracerebral hemorrhage (HICH) is a very common neurosurgical disease disorder with a poor prognosis and outcome. The hematoma is generally located in the brain parenchyma such as the basal ganglia 1-3. Recently, endoscopic surgery for the hematoma evacuation has gradually replaced craniotomy to minimize brain injury 4,5. Endoscopic techniques is a new method of minimally invasive operation that have the advantages of less trauma, fewer complications, and better prognosis. Compared with traditional craniotomy, the accurate localization of the hematoma is more important in endoscopic surgeries. Precise insertion of the puncturing needle or sheath is the crucial factor of the accomplishment of operation 6,7. Hence, we need a low-cost and easy-to-follow technique to localize the deep-seated hematoma. 3D printing technology is based on the original digital imaging and communications in medicine (DICOM) data of CT and 3D software modeling. On the basis of this technology, the shape and position of hematomas in patients are analyzed, and the surgical approach is designed to avoid important positions, such as those of the venous sinus, the functional area, and the forehead sinus 8. According to the facial features of the patients, an individualized facial model with the guide orifice is designed and printed by a 3D printer. In the hematoma puncture process, the puncture angle and the puncture position can be fixed through the guide orifice, which reduces the tissue injury, caused by the inaccurate localization and repeated puncture. This method for the treatment of HICH by neuroendoscopy is personalized and more accurate than the conventionally used ones.

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Section: Discussionmentioning

confidence: 99%

3D-printed model-guided endoscopic evacuation for basal ganglia hemorrhage

Zhang¹,

Cheng

Zhou

et al. 2020

Sci Rep

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“…2,7,8) Our technique and experience may solve these functional and technical problems. 9,10) Next, we will evaluate the long-term outcomes in patients who underwent the freehand technique, and develop new endoscopic tools.…”

Section: Discussionmentioning

confidence: 99%

Freehand Technique for Putaminal Hemorrhage-Technical Note-

Yokosuka

Uno

Hirano

et al. 2011

Neurol. Med. Chir.(Tokyo)

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We designed a new endoscopic surgical procedure for putaminal hemorrhage (freehand technique) and evaluated its effectiveness and safety in patients with putaminal hemorrhage. Computed tomography (CT) data sets from 40 healthy patients were used. The CT data were transformed into three-dimensional images using AZE VirtualPlace TM Plus. The nasion and external auditory foramen were the intraoperative reference points. The median point from medial of the globus pallidus to the insula was the target point. The location of the burr hole point was 80-125 mm above and 27.5 mm lateral to the nasion, and the direction was parallel to the midline and a line drawn from the burr hole to the ipsilateral external auditory foramen. This point was used for 15 patients with putaminal hemorrhage. In all cases, only one puncture was required, and there were no complications. The median surgical time was 91.7 minutes, and the median hematoma removal rate was 95.9%. No recurrent bleeding or operative complications occurred. The freehand technique is a simple and safe technique for patients with putaminal hemorrhage. We believe that this technique of endoscopic hematoma evacuation may provide a less-invasive method for treating patients with putaminal hemorrhage.

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“…Besides the standard navigation system, there are more available options such as using iPhone or iPod to identify the location on scalp of the patient with pre-operative CT. 38 , 48 Image-guided surgery mainly based on CT to target hypertensive hemorrhage were described by neurosurgeons worldwide instead of neuronavigation. 26 , 49 , 50 , 51 , 52 , 53 …”

Section: Crucial Technique Points and Options For Endoscopic Evacuatimentioning

confidence: 99%

Endoscopic treatment of hypertensive intracerebral hemorrhage: A technical review

Zhao¹,

Chen²

2016

Chronic Diseases and Translational Medicine

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Hypertensive intracerebral hemorrhage (ICH) is still a highlighting global issue. Endoscopic evacuation as a minimally invasive treatment became an alternative other than conventional craniotomy and catheter drainage for ICH. However, there is no unified indication or standardized procedure on endoscopic treatment of ICH. Here we explored the literature and gathered information from different studies, to review the background, technical points, and existing problems of endoscopic treatment for ICH.

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Three-dimensional reconstructed CT scanning for targeting hypertensive putaminal hemorrhage

Cited by 7 publications

References 12 publications

3D-printed model-guided endoscopic evacuation for basal ganglia hemorrhage

3D-printed model-guided endoscopic evacuation for basal ganglia hemorrhage

Freehand Technique for Putaminal Hemorrhage-Technical Note-

Endoscopic treatment of hypertensive intracerebral hemorrhage: A technical review

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