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[Surgery for a Refractory Chronic Subdural Hematoma Using an Exoscope:A Technical Case Report].
Takashi Fujimoto1, Yoichi Morofuji, Ryotaro Takahira
1Department of Neurosurgery, Nagasaki University School of Medicine.
No Shinkei Geka. Neurological Surgery
|May 8, 2019
Summary
Refractory chronic subdural hematoma (CSDH) cases can be challenging. Mini-craniotomy with an exoscope offers an effective solution for CSDH recurrence, providing a successful alternative to repeated burr-hole surgeries.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Chronic subdural hematoma (CSH) is typically managed with burr hole irrigation and drainage.
- Refractory CSH cases present significant treatment challenges.
- Recurrent CSH necessitates advanced surgical interventions.
Purpose of the Study:
- To evaluate the efficacy of mini-craniotomy with exoscope-assisted hematoma evacuation for refractory CSH.
- To present a case study of successful CSH management using this minimally invasive technique.
Main Methods:
- A patient with recurrent CSH and neurological deficits underwent CT head imaging.
- The patient was treated with a mini-craniotomy and exoscope-guided hematoma evacuation.
- Post-operative follow-up assessed for recurrence and clinical improvement.
Main Results:
- The patient presented with disturbance of consciousness and left hemiparesis due to right CSH.
- Three prior burr hole irrigation surgeries failed to resolve the CSH.
- Following mini-craniotomy and exoscope-assisted evacuation, the patient experienced an uneventful recovery with no recurrence at follow-up.
Conclusions:
- Mini-craniotomy with exoscope-assisted evacuation is a viable and effective option for refractory CSH.
- This approach may reduce recurrence rates in complex CSH cases.
- Exoscope use enhances visualization and precision in CSH evacuation procedures.
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