Endoscopic treatment of septated chronic subdural hematoma

Hellwig, Dieter; Kuhn, Thomas J.; Bauer, B. L.; List-Hellwig, E.

doi:10.1016/0090-3019(95)00417-3

Cited by 90 publications

(51 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,13 Recently, minimally invasive surgery with a rigid or flexible endoscope for chronic SDH has been successfully demonstrated. 2,3,9,11,14 In a few previous reports bur hole surgery was performed for subacute SDH, with good outcomes. 5,6,16 Yamada et al reported on 20 patients in whom subacute SDH was treated with bur hole surgery.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Yokosuka

Uno

Matsumura

et al. 2015

JNS

View full text Add to dashboard Cite

abbreviatioNs GCS = Glasgow Coma Scale; mRS = modified Rankin Scale; SDH = subdural hematoma. subMitted April 30, 2014. accepted October 17, 2014. iNclude wheN citiNg Published online April 24, 2015; DOI: 10.3171/2014.10.JNS14915. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patientsKimihiko Yokosuka, Md, phd, Masaaki uno, Md, phd, Kohei Matsumura, Md, hiroki takai, Md, hirotaka hagino, Md, Nobuhisa Matsushita, Md, phd, hiroyuki toi, Md, and shunji Matsubara, Md, phd Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan obJect Endoscopic surgery was performed for acute or subacute subdural hematoma (SDH), and its effectiveness and safety in elderly patients were evaluated. Methods Between September 2007 and November 2013, endoscopic surgery was performed in 11 elderly patients with acute SDH (8 patients) and subacute SDH (3 patients). The criteria for surgery were as follows: 1) the presence of clinical symptoms; 2) age older than 70 years; 3) no brain injury (intracerebral hematoma, brain contusion); 4) absence of an enlarging SDH; and 5) no high risk of bleeding. Hematoma evacuation was performed with a 4-mm rigid endoscope with a 0° lens and a malleable irrigation suction cannula. results Endoscopic surgery was performed under local anesthesia. The mean age of the patients was 82.6 years (range 73-91 years). There were 5 female and 6 male patients. The mean preoperative Glasgow Coma Scale score was 12, and 5 patients had been receiving antithrombotic drug therapy. The mean operation time was 85 minutes. Only 1 patient had rebleeding, and reoperation with the same technique was performed uneventfully in this individual. A total of 7 patients had a good recovery (modified Rankin Scale Score 0-2) at discharge. coNclusioNs Endoscopic hematoma evacuation of acute and subacute SDH is a safe and effective method of clot removal that minimizes operative complications. This technique may be a less invasive method for treating elderly patients with acute and subacute SDHs.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Yokosuka

Uno

Matsumura

et al. 2015

JNS

View full text Add to dashboard Cite

show abstract

“…Endoscopic evacuation of chronic subdural hemato mas in adults has been reported by Hellwig et al [ 11 ], who found the endoscope to be particularly useful in opening septations and ncomembranes; they reported a successful outcome in 12 (86%) of 14 patients treated with endosco py alone. During the 8 years that we have used endo scopes to treat subdural hematomas, we have developed an algorithm that maintains the current trend toward noninvasive management; this algorithm is summarized in figure 4.…”

Section: Discussionmentioning

confidence: 96%

Endoscopic Washout: A New Technique for Treating Chronic Subdural Hematomas in Infants

Gruber

Crone²

1997

Pediatr Neurosurg

View full text Add to dashboard Cite

Chronic hematomas are a common problem during infancy and usually occur as the consequence of trauma. They tend to enlarge and are often managed successfully with repeated subdural taps. In patients with collections that fail to respond to percutaneous drainage, the choice of operative management, including burr hole evacuation, shunting, or craniotomy, remains controversial. A new technique, called endoscopic washout, was successfully used in 7 children under the age of 2 years who presented with irritability, vomiting, seizures, and rapid head growth. Preoperative computerized tomography (CT) scans demonstrated enlarging, bilateral, chronic subdural collections; these failed to respond to repeated percutaneous taps over 10 days. With the patient positioned supine, bilateral linear incisions were made anterior to the coronal suture in the midpupillary lines and burr holes were placed. After the dura and outer membrane were opened and coagulated with bipolar cautery, a 4-mm steerable fiberscope was introduced into the subdural space to visualize the collections, evacuate any residual clot, and continuously irrigate the space with lactated Ringer’s solution warmed to physiologic temperature. No bridging vessels or synechiae were violated; nitrous oxide and hyperventilation were discontinued before removing the fiberscope. The subdural space was irrigated again prior to closure. At follow-up (range 18 months to 8 years), CT scans showed reexpansion of the brain and no reaccumulation of the hematomas. We conclude that the endoscopic washout is a safe, uncomplicated treatment for chronic subdural hematomas in infants; is more effective than treatment with conventional burr holes alone, and eliminates the need for shunting or craniotomy.

show abstract

“…More recently, neuroendoscopes have been utilized in the surgical procedures for CSDH treatment. Neuroendoscopic techniques for the treatment of septated CSDHs were introduced in 1992 using flexible-steerable endoscopes through a burr-hole approach 5,6) and small microscissors or microforceps for resection of the neomembranes. 6) Another neuroendoscopic technique for treating CSDH was introduced in 1995 based on small craniectomy under local standby anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Neuroendoscopic techniques for the treatment of septated CSDHs were introduced in 1992 using flexible-steerable endoscopes through a burr-hole approach 5,6) and small microscissors or microforceps for resection of the neomembranes. 6) Another neuroendoscopic technique for treating CSDH was introduced in 1995 based on small craniectomy under local standby anesthesia. 15) The main advantage of this method is access to almost the entire hematoma cavity through the small craniectomies performed under local standby anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscope-Assisted Removal of an Organized Chronic Subdural Hematoma in a Patient on Bevacizumab Therapy-Case Report-

Takahashi

Yazaki

Nitori

et al. 2011

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 78-year-old Japanese man with a history of colon cancer was referred to our department of neurosurgery for the management of asymptomatic left chronic subdural hematoma (CSDH). He was receiving bevacizumab therapy for colon cancer, and the size of the CSDH increased or decreased depending on bevacizumab administration. Simple drainage was performed because of the risk of a critical increase in the size of CSDH during bevacizumab therapy, but since the CSDH was organized and firm, the drainage was insufficient. Therefore, neuroendoscope-assisted craniotomy was performed, and the organized CSDH was almost completely removed. The present case indicates the possible involvement of bevacizumab in the occurrence of CSDH and the efficacy of the neuroendoscopic approach in the surgical treatment of organized CSDH.

show abstract

Endoscopic treatment of septated chronic subdural hematoma

Cited by 90 publications

References 19 publications

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Endoscopic hematoma evacuation for acute and subacute subdural hematoma in elderly patients

Endoscopic Washout: A New Technique for Treating Chronic Subdural Hematomas in Infants

Neuroendoscope-Assisted Removal of an Organized Chronic Subdural Hematoma in a Patient on Bevacizumab Therapy-Case Report-

Contact Info

Product

Resources

About