Nonacute Subdural Hematoma Evacuation Using a Rigid Endoscopy System: A Clinical Study
Turkish Neurosurgery, vol.34, no.6, pp.1102-1109, 2024 (SCI-Expanded, Scopus)
- 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.