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

Emrah Egemen1, Umit Akin Dere, Emrah Celtikci

  • 1Pamukkale University School of Medicine, Department of Neurosurgery, Denizli, Türkiye.

Turkish Neurosurgery
|October 30, 2024
PubMed
Summary

Rigid endoscopy offers a safe and feasible surgical method for draining subdural hematomas. This technique showed acceptable morbidity and mortality, with neurological grade impacting patient outcomes.

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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.