Evacuation of subdural collections by endoscopy

Abstract

AIM Recent advances in neuroendoscopy demonstrated that intraoperative use of the endoscope improves visualization of critical structures, especially behind corners and deep area. Treatment of chronic subdural haematoma (SDH) using endoscopic-assisted techniques is a minimally invasive method that may provide an addition to the standard technique of burr-hole craniostomy drainage. MATERIAL AND METHODS Over a 24-month period, authors used endoscopic assistance with minicraniotomy drainage, and prospectively collected data to review the technique. A total of 10 procedures (8 patients) were attempted with endoscopic assistance. Four of them were chronic subdural hematoma and six of them were subacute subdural hematomas. RESULTS Procedures were extended 20 minutes in average due to endoscopic intervention. There was no additional morbidity throughout the study as a result of endoscopic inspection. CONCLUSION We conclude that in selected circumstances endoscopic-assisted techniques can make the procedure safer with enhanced intra-operative visualization and may also allow for the identification and destruction of neomembranes, septums and solid clots. In addition, the source of bleeding can be stopped. The endoscopic-assisted techniques, with all of these features can alter the pre- and intra-operative decision-making for some of the patients.