M Berhouma1, T Jacquesson, E Jouanneau. 1. Minimally Invasive and Endoscopic Neurosurgery Program, Pierre Wertheimer Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, 69500, France, berhouma.moncef@gmail.com.
Abstract
BACKGROUND: Fibrin membranes and compartmentalization within the subdural space are a frequent cause of failure in the treatment of chronic subdural hematomas (CSH). This specific subtype of CSH classically requires craniotomy, which carries significant morbidity and mortality rates, particularly in elderly patients. In this work, we describe a minimally invasive endoscopic alternative. METHODS: Under local scalp anesthesia, a rigid endoscope is inserted through a parietal burr hole in the subdural space to collapse fibrin septa and cut the internal membrane. It also allows cauterization of active bleedings and the placement of a drain under direct visualization. CONCLUSIONS: The endoscopic treatment of septated CSH represents a minimally invasive alternative to craniotomy especially for the internal membranectomy.
BACKGROUND: Fibrin membranes and compartmentalization within the subdural space are a frequent cause of failure in the treatment of chronic subdural hematomas (CSH). This specific subtype of CSH classically requires craniotomy, which carries significant morbidity and mortality rates, particularly in elderly patients. In this work, we describe a minimally invasive endoscopic alternative. METHODS: Under local scalp anesthesia, a rigid endoscope is inserted through a parietal burr hole in the subdural space to collapse fibrin septa and cut the internal membrane. It also allows cauterization of active bleedings and the placement of a drain under direct visualization. CONCLUSIONS: The endoscopic treatment of septated CSH represents a minimally invasive alternative to craniotomy especially for the internal membranectomy.
Authors: Jorge F Urquiaga; Mayur S Patel; Najib El Tecle; Nabiha Quadri; Georgios Alexopoulos; Richard D Bucholz; Philippe J Mercier; Joanna M Kemp; Jeroen Coppens Journal: Cureus Date: 2022-08-01