Minimal Invasive Surgery for Chronic Subdural Hematoma
DOI:
https://doi.org/10.36552/pjns.v25i3.572Keywords:
Glasgow Coma Scale, Chronic Subdural Hematoma, Minimal Invasive Surgery.Abstract
Objective: To assess significant improvement in terms of the Glasgow Coma Scale in patients subjected to minimally invasive surgery for a chronic subdural hematoma.
Materials and Methods: A total of 80 patients with chronic subdural hematoma (CSDH) were enrolled in a sequential fashion using a retrospective study design. The patients were treated with minimally invasive surgery (MIS) and assessed at the end of the 2nd postoperative day (POD) for any significant improvement in the Glasgow coma scale (GCS).
Results: There were 76.25% male and 23.75% female patients. A maximum number of patients (42.5%) were found with a GCS ranging from 9/15 – 11/15 (Class B) followed by Class A having GCS 12-13 (36.25%) and then Class C with GCS 5 – 8 (21.25% patients). In 86.2% and 13.7& of the patients, positive and negative outcomes were recorded. Maximum favorable surgical outcome was observed in 51-60 years of age group. In the majority of male patients, a favorable surgical outcome was reported. Similarly, a favorable surgical outcome was observed in Class B (GCS 9-11). There existed an insignificant difference between favorable surgical outcome vs. age groups, gender, and GCS class at baseline.
Conclusion: This study found that CSDH using the MIS approach is linked to a high frequency of positive outcomes in terms of GCS improvement. A lower admission GCS score and older age are linked to a lower frequency of favorable outcomes and a higher likelihood of bad outcomes.
References
2. Liu W, Bakker NA, Groen RJM. Chronic subdural hematoma: A systematic review and meta-analysis of surgical procedures. J Neurosurg. 2014;121(3):665–73.
3. Edlmann E, Hutchinson PJ, Kolias AG. Chronic subdural haematoma in the elderly. Brain Spine Surg Elder. 2017;(October 2001):353–71.
4. Tseng JH, Tseng MY, Liu AJ, Lin WH, Hu HY, Hsiao SH. Risk Factors for Chronic Subdural Hematoma after a Minor Head Injury in the Elderly: A Population-Based Study. Biomed Res Int. 2014;2014.
5. Liu Y, Xia JZ, Wu AH, Wang YJ. Burr-hole craniotomy treating chronic subdural hematoma: A report of 398 cases. Chinese J Traumatol - English Ed [Internet]. 2010;13(5):265–9. Available from: http://dx.doi.org/10.3760/cma.j.issn.1008-1275.2010.05.002
6. Roh D, Reznik M, Claassen J. Chronic Subdural Medical Management. Neurosurg Clin N Am [Internet]. 2017;28(2):211–7. Available from: http://dx.doi.org/10.1016/j.nec.2016.11.003
7. Malgie J, Schoones JW, Pijls BG. Studies Ce Pt E D Us Cr Ip T Ce Pt E Us Cr T. 2020;1–18.
8. Dorosh J, Keep MF. Minimally Invasive Subacute to Chronic Subdural Hematoma Evacuation with Angled Matchstick Drill and Repurposed Antibiotic Ventriculostomy Catheter Augmented with Alteplase: A Technical Case Report. Cureus. 2019;11(11):1–10.
9. Buchanan IA, Mack WJ. Minimally Invasive Surgical Approaches for Chronic Subdural Hematomas. Neurosurg Clin N Am [Internet]. 2017;28(2):219–27. Available from: http://dx.doi.org/10.1016/j.nec.2016.11.004
10. Latini MF, Fiore CA, Romano LM, Spadaro E, Zorrilla JP, Gonorazky SE, et al. Tratamiento mínimamente invasivo del hematoma subdural crónico del adulto. Resultados en 116 pacientes. Neurologia [Internet]. 2012;27(1):22–7. Available from: http://dx.doi.org/10.1016/j.nrl.2011.05.001
11. Cai Q, Guo Q, Zhang F, Sun D, Zhang W, Ji B, et al. Evacuation of chronic and subacute subdural hematoma via transcranial neuroendoscopic approach. Neuropsychiatr Dis Treat. 2019;15:385–90.
12. Berhouma M, Jacquesson T, Jouanneau E. The minimally invasive endoscopic management of septated chronic subdural hematomas: surgical technique. Acta Neurochir (Wien). 2014;156(12):2359–62.
13. Certo F, Maione M, Altieri R, Garozzo M, Toccaceli G, Peschillo S, et al. Pros and cons of a minimally invasive percutaneous subdural drainage system for evacuation of chronic subdural hematoma under local anesthesia. Clin Neurol Neurosurg [Internet]. 2019;187(August):105559. Available from: https://doi.org/10.1016/j.clineuro.2019.105559
14. Mostofi K, Peyravi M, Moghaddam BG. Minimally Invasive Surgical Approach for Treatment of Chronic Subdural Hematoma, Outcome in 1079 Patients. Turk Neurosurg. 2021;31(1):18–23.
15. Lee HS, Song SW, Chun Y Il, Choe WJ, Cho J, Moon CT, et al. Complications following burr hole craniostomy and closed-system drainage for subdural lesions. Korean J Neurotrauma. 2018;14(2):68–75.
16. Article O. Ishfaq_2017_Subdural vs Subgaleal drain_CSDH. 2017;27(July 2015):419–22.
17. Farhat Neto J, Araujo JLV, Ferraz VR, Haddad L, Veiga JCE. Hematoma subdural crônico: Análise epidemiológica e prognóstica de 176 casos. Rev Col Bras Cir. 2015;42(5):283–7.
18. Amirjamshidi A, Abouzari M, Eftekhar B, Rashidi A, Rezaii J, Esfandiari K, et al. Outcomes and recurrence rates in chronic subdural haematoma. Br J Neurosurg. 2007;21(3):272–5.
19. Viaroli E, Iaccarino C, Maduri R, Daniel RT, Servadei F. Complications after surgery for chronic subdural hematomas [Internet]. Complications in Neurosurgery. Elsevier Inc.; 2018. 274–279 p. Available from: https://doi.org/10.1016/B978-0-323-50961-9.00045-1
20. Rauhala M, Helén P, Huhtala H, Heikkilä P, Iverson GL, Niskakangas T, et al. Chronic subdural hematoma—incidence, complications, and financial impact. Acta Neurochir (Wien). 2020;162(9):2033–43.
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