Endoscopic support for the surgical treatment of chronic subdural hematomas
Keywords:
brain injuries, chronic subdural hematoma, neuroendoscopy.Abstract
Introduction: Chronic subdural hematoma is a common entity in neurosurgery. Currently, multiple therapeutic modalities are described and surgical evacuation with endoscopic support is increasingly used.Objective: To describe the surgical results of endoscopic support in patients with chronic subdural hematoma.
Method: A descriptive and retrospective study was carried out, which included 31 patients, at the Hermanos Ameijeiras hospital, operated on for chronic subdural hematoma using transcranial approaches with endoscopic support. Sociodemographic, clinical, imaging, surgical and complications related to the procedure variables are described. For data analysis, absolute and relative frequencies were used.
Results: The most used surgical technique was using 2 burr holes with endoscopic support (83.9 %). Total evacuation was reported in 96.8 % of patients. Postoperative complications identified (3.2 %) were: Pneumocephalus, residual hematoma, and recurrence.
Conclusions: Endoscopic support in the surgical evacuation of chronic subdural hematomas constitutes a safe and effective method with a significant reduction in postoperative complications, especially in the incidence of hematoma recurrence.
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References
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19. Zhang J, Liu X, Fan X, Fu K, Xu C, Hu Q. The use of endoscopic-assisted burr-hole craniostomy for septated chronic subdural haematoma: A retrospective cohort comparison study [Internet]. Brain Res. 2018; 1678:245-53. DOI: 10.1016/j.brainres.2017.10.017
20. Wu L, Guo X, Ou Y, Yu X, Zhu B, Yang C. Efficacy analysis of neuroendoscopy-assisted burr-hole evacuation for chronic subdural hematoma: a systematic review and meta-analysis [Internet]. Neurosurg Rev. 2023; 46(1):98. DOI: 10.1007/s10143-023-02007-2
21. Yadav YR, Ratre S, Parihar V, Bajaj J, Sinha M, Kumar A. Endoscopic management of chronic subdural hematoma [Internet]. J Neurol Surg A Cent Eur Neurosurg. 2020; 81(4):330-41. DOI: 10.1055/s-0039-1698388
22. Deng J, Wang F, Wang H, Zhao M, Chen G, Shangguan H, et al. efficacy of neuroendoscopic treatment for septated chronic subdural hematoma [Internet]. Front Neurol. 2022; 12:765109. DOI: 10.3389/fneur.2021.765109
2. Huang J, Gao C, Dong J, Zhang J, Jiang R. Drug treatment of chronic subdural hematoma. Expert Opin Pharmacother [Internet]. 2020; 21(4):435-444. DOI: 10.1080/14656566.2020.1713095
3. Feghali J, Yang W, Huang J. updates in chronic subdural hematoma: epidemiology, etiology, pathogenesis, treatment, and outcome [Internet]. World Neurosurg. 2020; 141:339-345. DOI: 10.1016/j.wneu.2020.06.140
4. Merrill SA, Khan D, Richards AE, Kalani MA, Patel NP, Neal MT. Functional recovery following surgery for chronic subdural hematoma [Internet]. Surg Neurol Int. 2020; 11:450. DOI: 10.25259/SNI_689_2020
5. Haseeb A, Shafique MA, Kumar A, Raqib MA, Mughal ZUN, Nasir R, et al. Efficacy and safety of steroids for chronic subdural hematoma: A systematic review and meta-analysis [Internet]. Surg Neurol Int. 2023; 14:449. DOI: 10.25259/SNI_771_2023
6. Karibe H, Narisawa A, Nagai A, Yamanouchi S, Kameyama M, Nakagawa A, et al. Incidence of Chronic Subdural Hematoma after Mild Head Trauma in Elderly Patients with or without Pre-traumatic Conditioning of Anti-thrombotic Drugs [Internet]. Neurol Med Chir (Tokyo). 2023; 63(3):91-96. DOI: 10.2176/jns-nmc.2022-0327
7. Yadav YR, Ratre S, Parihar V, Bajaj J, Sinha M, Kumar A. Endoscopic Management of chronic subdural hematoma. J Neurol Surg A Cent Eur Neurosurg [Internet]. 2020; 81(4):330-341. DOI: 10.1055/s-0039-1698388
8. Feghali J, Yang W, Huang J. Updates in Chronic Subdural Hematoma: Epidemiology, Etiology, Pathogenesis, Treatment, and Outcome [Internet]. World Neurosurg. 2020; 141:339-345. DOI:10.1016/j.wneu.2020.06.140
9. Adetunmbi B, Adebayo BO, Bankole OB, Adeyomoye AA, Morgan E, Kanu OO. Chronic Subdural Hematoma: Predicting Postoperative Recurrence Using a Correlation of Computerized Tomographic Volume with Intraoperative Volume. J West Afr Coll Surg [Internet]. 2023; 13(4):40-45. DOI:10.4103/jwas.jwas_37_23
10. Nakaguchi H, Tanishima T, Yoshimasu N. Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence [Internet]. J Neurosurg. 2001;95(2):256-262. DOI:10.3171/jns.2001.95.2.0256
11. Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, et al. The ABCs of measuring intracerebral hemorrhage volumes [Internet]. Stroke. 1996; 27(8):1304-5. DOI: 10.1161/01.str.27.8.1304
12. Taalas W, Raj R, Öhman J, Siironen J. Long-Term Functional Outcome and Quality of Life in Long-Term Traumatic Brain Injury Survivors [Internet]. Neurotrauma Rep. 2023; 4(1):813-22. DOI: 10.1089/neur.2023.0064
13. Gelabert-González M, Román-Pena P, Arán-Echabe E. Chronic subdural hematoma in the oldest-old population [Internet]. Neurosurg Rev. 2018; 41(4):983-4. DOI: 10.1007/s10143-017-0852-x
14. Yagnik KJ, Goyal A, Van Gompel JJ. Twist drill craniostomy vs burr hole drainage of chronic subdural hematoma: a systematic review and meta-analysis. Acta Neurochir (Wien) [Internet]. 2021; 163(12):3229-41. DOI: 10.1007/s00701-021-05019-3
15. Huang YW, Yin XS, Li ZP. Burr hole craniostomy vs. minicraniotomy of chronic subdural hematoma: a systematic review and meta-analysis [Internet]. Eur Rev Med Pharmacol Sci. 2022; 26(14):4983-90. DOI: 10.26355/eurrev_202207_29284
16. Guan F, Peng WC, Huang H, Dai B, Zhu GT, Xiao ZY, et al. Efficacy analysis of flexible neuroendoscopy combined with dry-field techniques in the treatment of chronic subdural hematoma [Internet]. Chin Med J (Engl). 2019; 132(11):1359-62. DOI: 10.1097/CM9.0000000000000249
17. Almenawer SA, Farrokhyar F, Hong C, Alhazzani W, Manoranjan B, Yarascavitch B, et al. Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients [Internet]. Ann Surg. 2014; 259(3):449-57. DOI: 10.1097/SLA.0000000000000255
18. Singh H, Patir R, Vaishya S, Miglani R, Gupta A, Kaur A. Endoscopic evacuation of septated chronic subdural hemorrhage - Technical considerations, results, and outcome [Internet]. Surg Neurol Int. 2022; 13:8. DOI: 10.25259/SNI_963_2021
19. Zhang J, Liu X, Fan X, Fu K, Xu C, Hu Q. The use of endoscopic-assisted burr-hole craniostomy for septated chronic subdural haematoma: A retrospective cohort comparison study [Internet]. Brain Res. 2018; 1678:245-53. DOI: 10.1016/j.brainres.2017.10.017
20. Wu L, Guo X, Ou Y, Yu X, Zhu B, Yang C. Efficacy analysis of neuroendoscopy-assisted burr-hole evacuation for chronic subdural hematoma: a systematic review and meta-analysis [Internet]. Neurosurg Rev. 2023; 46(1):98. DOI: 10.1007/s10143-023-02007-2
21. Yadav YR, Ratre S, Parihar V, Bajaj J, Sinha M, Kumar A. Endoscopic management of chronic subdural hematoma [Internet]. J Neurol Surg A Cent Eur Neurosurg. 2020; 81(4):330-41. DOI: 10.1055/s-0039-1698388
22. Deng J, Wang F, Wang H, Zhao M, Chen G, Shangguan H, et al. efficacy of neuroendoscopic treatment for septated chronic subdural hematoma [Internet]. Front Neurol. 2022; 12:765109. DOI: 10.3389/fneur.2021.765109
Published
2024-07-23
How to Cite
1.
Ortiz Machín MM, López Arbolay O, Vargas Gálvez CR, Arzeno Valdivia EA, Davilus D, Mejía Castro PF. Endoscopic support for the surgical treatment of chronic subdural hematomas. Rev Cubana Med Milit [Internet]. 2024 Jul. 23 [cited 2025 Apr. 3];53(3):e024038208. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/38208
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Clinical Practice Article
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