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


EGEMEN E., DERE U. A., ÇELTİKÇİ E., NEHIR A., DOGRUEL Y., SAHINOGLU D., ...More

Turkish Neurosurgery, vol.34, no.6, pp.1102-1109, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 34 Issue: 6
  • Publication Date: 2024
  • Doi Number: 10.5137/1019-5149.jtn.46194-23.2
  • Journal Name: Turkish Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Page Numbers: pp.1102-1109
  • Keywords: Endoscopy, Hematoma, Minimally invasive, Subdural
  • Ankara University Affiliated: Yes

Abstract

AIM: To determine the clinical relevance of a rigid endoscopy surgical method for subdural hematomas, as previously described in a cadaver study. MATERIAL and METHODS: Between May 2021 and September 2023, 21 patients underwent subdural hematoma drainage using a 0-degree rigid endoscope. Traumatic acute subdural hematomas were excluded. The demographic data of the patients, antiplatelet/antiaggregant use, perioperative findings, and pre- and post-surgery modified Rankin Scale (mRS) scores were recorded and analyzed. RESULTS: The mean age of our cohort was 65.63 (±20.52), and the male/female ratio was 3.2: 1. The hematoma was unilateral in 90.5% of the patients, and the rate of trauma history was 42.9%. The most common radiological diagnosis was chronic subdural hematoma with septa (61.9%). The percentage of patients with a history of antiplatelet/antiaggregant therapy was 23.8%. No mortality related to the surgery was observed in the early postoperative period; however, two patients underwent reoperation for further bleeding. The neurological grade was the only preoperative factor that had a statistically significant effect on the mRS score at discharge, with significantly better discharge mRS scores in grade 1 and 2 patients (p=0.014). CONCLUSION: The procedure was found to be safe and feasible, with surgery-related morbidity and mortality within acceptable limits.