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Neuroendoscopic Technique for Recurrent Chronic Subdural Hematoma with Small Craniotomy
Shinya Ichimura1, Kento Takahara, Masato Nakaya
1Shizuoka City Shimizu Hospital, Department of Neurosurgery, Shizuoka, Japan.
Turkish Neurosurgery
|July 25, 2020
Summary
This study presents an endoscopic technique using a small craniotomy for treating recurrent chronic subdural hematoma (rCSDH). The minimally invasive approach effectively removed hematomas and septations, showing a low regrowth rate.
Area of Science:
- Neurosurgery
- Minimally Invasive Procedures
Background:
- Recurrent chronic subdural hematoma (rCSDH) presents a significant clinical challenge.
- Existing treatments may have limitations in addressing complex rCSDH cases.
Purpose of the Study:
- To describe a novel endoscopic technique with a small craniotomy for rCSDH treatment.
- To evaluate the efficacy and safety of this minimally invasive approach.
Main Methods:
- A case series of 17 patients with rCSDH undergoing neuroendoscopic hematoma removal via a small craniotomy.
- Technique involved extending the initial incision, creating a small craniotomy, and using a rigid endoscope for evacuation, irrigation, and membrane management.
- Postoperative follow-up for at least 6 months.
Main Results:
- The technique demonstrated a low rCSDH regrowth rate of 5.9%.
- All cases were successfully managed, with one requiring repeat neuroendoscopy without further recurrence.
- The postoperative seizure rate was 23.5%.
Conclusions:
- The neuroendoscopic technique with a small craniotomy is a viable option for rCSDH.
- It allows for comprehensive visualization and evacuation of hematoma and septations.
- Facilitates brain expansion through inner membrane incision.
