Comparison of Surgical Outcomes and Recovery of Neurologic and Linguistic Functions in the Dominant Hemisphere After Basal Ganglia Hematoma Evacuation by Craniotomy versus Endoscopy

Xiong, Jianping; Zhenying, Han; Liu, Bingbing; Sun, Jian; Yu, Shukun; Tian, Ye; Wei, Huijie; Yu, Lin; Jiang, Rongcai; Yue, Shuyuan; Yang, Xuejun; Zhang, Jianning

doi:10.1016/j.wneu.2019.05.193

Cited by 10 publications

(12 citation statements)

References 41 publications

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“…However, craniotomy prolongs the operation and anesthesia time, and increases the risk of infection and epilepsy. Moreover, craniotomy increases the risk of damage to the speech center and the vein of Labbe, leading to increased chance of complications [9,15]. Keyhole operation transsylvian-transinsular was performed in this study for moderate basal ganglion hematoma, and avoided the above defects of craniotomy.…”

Section: Discussionmentioning

confidence: 96%

“…In clinical practice, hematoma with small volume (< 10 ml) can be treated with conservative measures and functional exercises for rehabilitation [7,8]. On the other hand, for large hematoma more than 30 ml which could threaten life or cause neurological dysfunction, surgery is essential [9,14]. However, different groups have recommended different surgical procedures [3,7,10].…”

Section: Discussionmentioning

confidence: 99%

“…However, different groups have recommended different surgical procedures [3,7,10]. To moderate volume basal ganglion hematoma ranging from 30 to 60 ml, there are several surgical procedures available, such as endoscopy operation, craniotomy, stereotactic aspiration and keyhole evacuation [9]. In this study, we introduced keyhole operation for moderate basal ganglion hematoma, and compared the complications and outcome with craniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The most common cause of SICH is hypertension, and about 60% of SICHs occur at the basal ganglia region [6,7]. Currently, the treatment of hematomas within the basal ganglia continues to be a matter of debate among neurologists and neurosurgeons [7][8][9]. The hematoma with small volume (< 30 ml of supratentorial) can be treated with conservative therapies, while larger hematoma (> 30 ml of supratentorial) is often removed through surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies showed that the removal of hematoma might reduce nervous tissue damage, possibly by relieving local ischemia and removing noxious chemicals [6][7][8]. However, different surgical procedures have been recommended by different neurosurgeons, such as craniotomy, endoscopy operation, stereotactic aspiration, and keyhole evacuation [8][9][10]. In this study, we present our series of cases of basal ganglia hematoma with volume ranged from 30 to 60 ml who underwent keyhole evacuation or traditional craniotomy, and compared the safety and effectiveness of keyhole surgery with traditional craniotomy.…”

Section: Introductionmentioning

confidence: 99%

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Keyhole Evacuation for moderate basal ganglia Hematoma superior than Craniotomy

Peng

Zhu²,

Lan³

et al. 2020

Preprint

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Background: Spontaneous intracerebral hemorrhage (SICH) is the most devastate kind of stokes.For basal ganglia hematoma with volume ranged from 30 to 60 ml, different surgical procedures have been recommended by different neurosurgeons.This study aimed to compare the clinical outcomes and hospitalization cost between keyhole surgery and craniotomy for basal ganglia intracerebral hemorrhage.Methods: A retrospective analysis was performed on clinical data of 63 cases of keyhole procedure and 56 cases of craniotomy procedure. Hematoma evacuation rate, infection rate, re-bleeding, operation time, hospitalization cost and outcome were recorded.Results: The evacuation rate was similar in keyhole group and craniotomy group (P>0.05), and infection rate was lower in keyhole group compared to craniotomy group (P<0.05). Mean operation time and hospitalization cost were less in keyhole group than in craniotomy group (P<0.05). Mortality rate between two groups showed no significant differences. The patients operated within 6h had better outcome than those operated between 6-24h (p<0.05).Conclusion: For patients with basal ganglia hematoma ranged from 30-60 ml, keyhole surgery is safe and feasible, and operation within 6 h can improve the prognosis of the patients.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Keyhole Evacuation for moderate basal ganglia Hematoma superior than Craniotomy

Peng

Zhu²,

Lan³

et al. 2020

Preprint

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Use of Dyna-computed tomography-assisted neuroendoscopic hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage

Wang,

Tian,

Yang

et al. 2023

Neurosurg Rev

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The purpose of this study was to evaluate and summarize the technical characteristics and clinical e cacy of using Dyna computed tomography (CT)-assisted neuroendoscopic hematoma evacuation to treat hypertensive intracerebral hemorrhage (HICH). Patients and Methods: We treated 42 consecutive patients with HICH who underwent neuroendoscopic hematoma evacuation in our department from March 1, 2020 to May 31, 2022. Patients were divided into two groups: Dyna-CTassisted neuroendoscopic group (n = 18) and neuroendoscopic group (n = 24). Retrospective data, treatment e cacy, and outcomes were collected and compared between these two groups. ResultsThe operative time in the Dyna-CT-assisted neuroendoscopic group was signi cantly shorter than the operative time in the neuroendoscopic group (mean time 131.6 ± 13.51 vs. 156.6 ± 19.25 min, P < 0.001).Dyna-CT-assisted neuroendoscopic group had signi cantly less intraoperative blood loss than the neuroendoscopic group. (46.94 ± 10.42 vs. 106.46 ± 23.25, P = 0.003). However, patients who underwent Dyna-CT-assisted neuroendoscopic had a comparable hematoma clearance rate to those who underwent neuroendoscopic (89.36 ± 7.31 vs. 68.87 ± 19.44%, P = 0.006). The incidence of complications in the Dyna-CT-assisted neuroendoscopic group (5.6%) was lower than in the neuroendoscopic group (12.5%), but the difference was not statistically signi cant (P = 0.129). Patients who underwent Dyna-CT-assisted neuroendoscopic hematoma evacuation had better 6-month functional outcomes, and the difference was signi cant. (p = 0.004). Furthermore, multivariable analysis showed that younger age, smaller hematoma volume and Dyna-CT-assisted neuroendoscopic were predictors of favorable 6-month outcomes in HICH patients. ConclusionIn the treatment of HICH, Dyna-CT-assisted hematoma evacuation appears to be safer and more effective than neuroendoscopic hematoma evacuation. Dyna-CT-assisted neuroendoscopic hematoma evacuation in hybrid operating rooms may improve the clinical effect and outcomes of patients with HICH.

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Endoscopic Evacuation of Putaminal Hemorrhage Using the Trans-Middle Temporal Gyrus Approach: Technical Notes and Case Presentations

Yamazaki

Ogiwara

Kitamura

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims: The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for putaminal hematomas that extend into the temporal lobe. We adopted the endoscopic trans-middle temporal gyrus approach, instead of the conventional surgical approach, for the management of these complicated cases and determined its safety and feasibility. Patients and Methods: Twenty patients with putaminal hemorrhage underwent surgical treatment at the Shinshu University Hospital between January 2016 and May 2021. Of these, two patients with left putaminal hemorrhage that extended into the temporal lobe underwent surgical treatment using the endoscopic trans-middle temporal gyrus approach. The procedure entailed the use of a thinner transparent sheath to reduce the technique’s invasiveness, a navigation system to determine the location of the middle temporal gyrus and the sheath’s trajectory, and an endoscope with a 4K camera for higher image quality and utility. The Sylvian fissure was compressed superiorly using our novel “port retraction technique” (i.e., by tilting the transparent sheath superiorly) to avoid damage to the middle cerebral artery and the Wernicke’s area. Results: The endoscopic trans-middle temporal gyrus approach allowed sufficient hematoma evacuation and hemostasis under endoscopic observation without any surgical complexities or complications. The postoperative course was uneventful in both patients. Conclusion: The endoscopic trans-middle temporal gyrus approach for putaminal hematoma evacuation helps avoid damage to normal brain tissue, which could result from the wide range of motion of the conventional technique, particularly when the hemorrhage extends to the temporal lobe.

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Comparison of Surgical Outcomes and Recovery of Neurologic and Linguistic Functions in the Dominant Hemisphere After Basal Ganglia Hematoma Evacuation by Craniotomy versus Endoscopy

Cited by 10 publications

References 41 publications

Keyhole Evacuation for moderate basal ganglia Hematoma superior than Craniotomy

Keyhole Evacuation for moderate basal ganglia Hematoma superior than Craniotomy

Use of Dyna-computed tomography-assisted neuroendoscopic hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage

Endoscopic Evacuation of Putaminal Hemorrhage Using the Trans-Middle Temporal Gyrus Approach: Technical Notes and Case Presentations

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