Minimally Invasive Intracerebral Hematoma Evacuation Using a Novel Cost-Effective Tubular Retractor: Single-Center Experience

We understand only a small fraction of the events happening in our brains; therefore, despite all the progress made thus far, a whole array of questions remains. Nonetheless, neurosurgeons invented new tools to circumvent the challenges that had plagued their predecessors. With the manufacturing boom of the 20th century, technological innovations blossomed enabling the neuroscientific community to study and operate upon the living brain in finer detail and with greater precision while avoiding harm to the nervous system. The purpose of this chronological review is to 1) raise awareness among future neurosurgeons about the latest advances in the field, 2) become familiar with innovations such as augmented reality (AR) that should be included in education given their ready applicability in surgical training, and 3) be comfortable with customizing these technologies to real-life cases like in the case of mixed reality.

show abstract

“…Apparently, this creative effort arises from the desire of moving the field forward despite the financial limitations. 92 , 93 )…”

Section: Limitationsmentioning

confidence: 99%

Evolution and Revolution of Imaging Technologies in Neurosurgery

Ogando‐Rivas

Castillo

Beltrán

et al. 2022

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…However, very few studies have evaluated prognosticators of outcome after endoscopic and endoport-assisted tubular ICH evacuation. 3 The ICH score is a ABBREVIATIONS: AC, anticoagulant; AP, antiplatelet; CTH, computed tomography of the head; Evac, evacuation; HR, hazard ratio; LTACH, long-term acute care hospital; mGraeb, modified Graeb; MIS, minimally invasive surgical; NIHSS, NIH Stroke Scale.…”

mentioning

confidence: 99%

“…However, very few studies have evaluated prognosticators of outcome after endoscopic and endoport-assisted tubular ICH evacuation. 3 The ICH score is a commonly used prognostic model to predict 30-day mortality after ICH; however, that model was validated in both medically and surgically managed patients and did not include modern MIS evacuation techniques. 4 An understanding of the predictors of functional outcomes after MIS evacuation using tubular retractor systems may help to better delineate ICH evacuation indications and prognosticate patient outcomes.…”

mentioning

confidence: 99%

Prognosticators of Functional Outcome After Supratentorial Minimally Invasive Intracranial Hemorrhage Evacuation With Tubular Retractor Systems

Kashkoush,

El-Abtah,

Achey

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Prognosticators of good functional outcome after minimally invasive surgical (MIS) intracranial hemorrhage (ICH) evacuation are poorly defined. This study aims to investigate clinical and radiographic prognosticators of poor functional outcome after MIS evacuation of ICH with tubular retractor systems. METHODS: Single-center retrospective review of adult (age ≥18 years) patients who underwent surgical evacuation of a spontaneous supratentorial ICH evacuation using tubular retractors from 2013 to 2022 was performed. Clinical and radiographic factors, such as antiplatelet/anticoagulant use, initial NIH Stroke Scale, ICH score, premorbid modified Rankin Scale (mRS), intraventricular hemorrhage (IVH) severity according to the modified Graeb scale, and preoperative/postoperative ICH volume, were collected. The main outcome was poor functional outcome, defined as mRS score of 4–6 within 1 year postoperatively. RESULTS: Eighty-eight patients were included. Clinical follow-up data were available for 64 (73%) patients. Of those, 43 (67%) had a poor functional outcome. On multivariate Cox regression, postoperative ICH volume ≥15 mL (hazard ratio [HR] = 2.46 [95% CI: 1.25-4.87]; P = .010) and higher modified Graeb score (HR = 1.04 [95% CI: 1-1.1]; P = .035] significantly increased the risk of poor functional outcome. Elevated postoperative ICH volume was predicted by the presence of lobar ICH (vs nonlobar, OR = 3.32 [95% CI: 1.01-11.55]; P = .043) and higher preoperative ICH volume (OR = 1.05 [1.02-1.08]; P < .001). A minimum of 60% ICH evacuation yielded an improvement in mRS 4–6 rates (HR 0.3 [95% CI: 0.1-0.8], P = .013). In patients without IVH and with a >80% ICH evacuation, the rate of mRS 4–6 was 42% compared with 67% in the whole patient sample (P = .017). CONCLUSION: Increased IVH volumes and residual postoperative ICH volumes are associated with poor functional outcome after MIS ICH evacuation. Postoperative ICH volume was associated with lobar ICH location as well as preoperative ICH volume. These factors may help to prognosticate patient outcomes and improve selection criteria for MIS ICH evacuation techniques.

show abstract

Brain retraction injury: systematic literature review

Roca,

Ramorino

2023

Neurosurg Rev

View full text Add to dashboard Cite

Minimally Invasive Intracerebral Hematoma Evacuation Using a Novel Cost-Effective Tubular Retractor: Single-Center Experience

Cited by 6 publications

References 28 publications

Evolution and Revolution of Imaging Technologies in Neurosurgery

Evolution and Revolution of Imaging Technologies in Neurosurgery

Prognosticators of Functional Outcome After Supratentorial Minimally Invasive Intracranial Hemorrhage Evacuation With Tubular Retractor Systems

Brain retraction injury: systematic literature review

Contact Info

Product

Resources

About