Nonacute Subdural Hematoma Evacuation Using a Rigid Endoscopy System: A Clinical Study

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Neurological Surgery

Background:

• Subdural hematomas require effective surgical intervention.
• Previous cadaver studies suggested rigid endoscopy as a potential method.
• Clinical relevance of this technique needed further investigation.

Purpose of the Study:

• To evaluate the clinical applicability and safety of rigid endoscopy for subdural hematoma drainage.
• To assess surgical outcomes and patient recovery following the procedure.

Main Methods:

• A prospective study involving 21 patients undergoing rigid endoscopic subdural hematoma drainage (May 2021-September 2023).
• Exclusion of traumatic acute subdural hematomas.
• Collection and analysis of demographic data, antiplatelet/antiaggregant use, perioperative findings, and modified Rankin Scale (mRS) scores.

Main Results:

• The cohort (mean age 65.63) predominantly had unilateral chronic subdural hematomas with septa (61.9%).
• No operative mortality; two patients required reoperation for bleeding.
• Preoperative neurological grade significantly correlated with discharge mRS scores (p=0.014).

Conclusions:

• Rigid endoscopy is a safe and feasible surgical approach for selected subdural hematomas.
• The procedure demonstrated acceptable surgery-related morbidity and mortality rates.
• Patient's preoperative neurological status is a key predictor of functional outcome.