endoscopic evacuation
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2022 ◽  
Vol 13 ◽  
pp. 8
Author(s):  
Harnarayan Singh ◽  
Rana Patir ◽  
Sandeep Vaishya ◽  
Rahul Miglani ◽  
Anurag Gupta ◽  
...  

Background: Chronic subdural hematoma (cSDH) is a common entity in the elderly. Homogeneous or well-liquefied CSDH has a standard line of treatment through burr hole and irrigation. However, the management of septated chronic subdural hematoma (sCSDH) with multiple membranes does not have a well-defined surgical approach. The neomembranes forming septations prevent evacuation of clots through burr holes, and the small remaining loculi with clots will enlarge overtime to cause recurrence. Methods: Patients with sCSDH were operated through a minicraniotomy (2.5 cm × 2.5 cm) using rigid endoscopes for visualization of the subdural space. Using endoscope, the entire subdural space can be visualized. The neomembranes are removed with standard neurosurgical microinstruments. The entire cavity is irrigated under vision to remove all clots and ensures hemostasis. Results: Eighty-three endoscope-assisted evacuations were done in 68 patients from January 2016 to April 2020. Fifty (73.5%) patients had unilateral and 18 (26.5%) had bilateral subdural. Only 1 patient (1.47%) had a clinically significant recollection of subdural bleeding 1 month after the procedure. Over a mean follow-up period of 25.3 months (range 1–53 months), rest of patients did not show any recollection. Conclusion: Endoscopic evacuation of sCSDH is a safe and effective method and can be used to improve clot evacuation, and remove neomembranes under direct vision to reduce the rates of recollection. This method also obviates the need for larger craniotomies to remove membranes.


Author(s):  
Rui Song ◽  
Muhammad Ali ◽  
Jonathan Pan ◽  
Colton Smith ◽  
Dominic A. Nistal ◽  
...  

Author(s):  
V. A. Mitish ◽  
M. A. Dvornikova ◽  
P. V. Medinskiy ◽  
I. V. Filinov ◽  
V. G. Bagaev ◽  
...  

Inferior gluteal artery pseudoaneurysms are rare, and most of the cases are due to blunt (pelvic fractures, femur’s dislocations) or penetrating trauma. Herein, we present a case of traumatic blunt rupture of an inferior gluteal artery pseudoaneurysm in adolescent 15th years old. Patient went through the complex examination and endosurgical treatment: endovascular occlusion of inferior gluteal artery and endoscopic evacuation of the large hematoma. Patient in short time came back to his ordinary live and sport.


2020 ◽  
Author(s):  
Nicolas K Khattar ◽  
Abigail P McCallum ◽  
Enzo M Fortuny ◽  
Andrew C White ◽  
Tyler J Ball ◽  
...  

Abstract BACKGROUND Acute subdural hematomas (aSDHs) occur in approximately 10% to 20% of all closed head injury and represent a significant cause of morbidity and mortality in traumatic brain injury patients. Conventional craniotomy is an invasive intervention with the potential for excess blood loss and prolonged postoperative recovery time. OBJECTIVE To evaluate the outcomes of minimally invasive endoscopy for evacuation of aSDHs in a pilot feasibility study. METHODS We retrospectively reviewed the records of consecutive patients with aSDHs who underwent surgical treatment at our institution with minimally invasive endoscopy using the Apollo/Artemis Neuro Evacuation Device (Penumbra, Alameda, California) between April 2015 and July 2018. RESULTS The study cohort comprised three patients. The Glasgow Coma Scale on admission was 15 for all 3 patients, median preoperative hematoma volume was 49.5 cm3 (range 44-67.8 cm3), median postoperative degree of hematoma evacuation was 88% (range 84%-89%), and median modified Rankin Scale at discharge was 1 (range 0-3). CONCLUSION Endoscopic evacuation of aSDHs can be a safe and effective alternative to craniotomy in appropriately selected patients. Further studies are needed to refine the selection criteria for endoscopic aSDH evacuation and evaluate its long-term outcomes.


2020 ◽  
Vol 144 ◽  
pp. 106-111
Author(s):  
Jonathan Yun ◽  
Michael M. McDowell ◽  
Paul A. Gardner ◽  
Georgios A. Zenonos

Author(s):  
Joy Abraham ◽  
Maulik Bhadaniya ◽  
Mayank Sharma ◽  
Devendra Talera ◽  
Hasmukh Vora ◽  
...  

2020 ◽  
Vol 11 ◽  
Author(s):  
Haixiao Liu ◽  
Xun Wu ◽  
Zhijun Tan ◽  
Hao Guo ◽  
Hao Bai ◽  
...  

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