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Updated: Sep 7, 2025
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
The Guidewire-assisted Drainage Catheter Placement in Chronic Subdural Hematoma
Bingjie Zheng1, Chunlei Wang1, Jinbiao Yao1
1Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Insights
This study introduces a guidewire-assisted technique for chronic subdural hematoma drainage, significantly reducing intracerebral hemorrhage risk. The method proved reliable and safe in 49 patients, with high success rates and minimal complications.
Area of Science:
- Neurosurgery
- Minimally Invasive Procedures
- Neurological Surgery
Background:
- Chronic subdural hematoma (cSDH) is a common condition in older adults.
- Burr hole drainage is a primary treatment for cSDH, but blind drain placement risks complications.
- Intracerebral hemorrhage is a potential complication of blind subdural drain placement.
Purpose of the Study:
- To describe a novel guidewire-assisted technique for subdural catheter placement in cSDH.
- To evaluate the safety and efficacy of this technique in reducing intracerebral hemorrhage.
- To present a reliable method for cSDH drainage with reduced morbidity.
Main Methods:
- The Guidewire-assisted Drainage Catheter Placement Technique was used in 49 consecutive cSDH patients.
- The technique utilizes an angular guidewire tip for controlled catheter insertion into the subdural space.
- Catheters were placed with 4-5 cm within the subdural space, tunneled subcutaneously, and secured.
Main Results:
- 55 procedures were performed on 49 patients (mean age 69.3 years; 37 male).
- No intracerebral hemorrhages or post-operative seizures occurred.
- 47 patients showed improvement, with only one recurrence, demonstrating high efficacy.
Conclusions:
- The Guidewire-assisted Drainage Catheter Placement Technique is a safe and reliable method for cSDH evacuation.
- This technique minimizes the risk of cortical structure and cerebral vein injury.
- It offers a low-risk alternative for managing chronic subdural hematomas.
Background:
Chronic subdural hematoma (cSDH) is a common neurosurgical pathology associated with older age. The burr hole drainage is a predominant technique with a lower incidence of recurrence and morbidity. The blind placement of the subdural drain could result in intracerebral hemorrhage. This paper describes a simple and reliable technique for drainage catheter placement in cSDH to reduce intracerebral hemorrhage.
Methods:
Forty-nine consecutive patients with cSDH were treated with The Guidewire-assisted Drainage Catheter Placement Technique between July 2019 and June 2021. Epidemiological, clinical and radiographical data were collected and reviewed. The operative technique consists of an angular guidewire tip and catheter. Under the navigation of the guidewire, the catheter is inserted into the subdural space and the length of catheter remaining in the subdural space was 4-5 cm. The catheter was tunneled subcutaneously and fixed at the point where it emerged from the scalp.
Results:
Forty-nine consecutive patients underwent 55 The Guidewire-assisted Drainage Catheter Placement. The gender distribution was 37 men and 12 women. The mean age was 69.3 years. The patients presented with headache (31 patients), weakness of limbs (28 patients), speech disturbances (7 patients), and Altered behavior (6 patients). Neither intracerebral hemorrhages nor post-operative seizure occurred. Forty-seven patients were improved after the operation. The recurrence occurred in one patient.
Conclusions:
The Guidewire-assisted Drainage Catheter Placement Technique is a reliable method for the insertion of a subdural catheter to evacuate of the Chronic Subdural Hematoma, and is associated with an extremely low risk to cortical structures and cerebral veins.
