Turkish Neurosurgery
Nonacute Subdural Hematoma Evacuation via Rigid Endoscopy System: A Clinical Study
Emrah Egemen1, Ümit Akın Dere1, Emrah Çeltikçi2, Ali Nehir3, Yücel Doğruel4, Defne Şahinoğlu1, Rasim Asar1, Batuhan Bakirarar5, Barış Albuz1, Mehmet Erdal Coşkun1, Fatih Yakar1
1Pamukkale University School of Medicine, Department of Neurosurgery, Denizli,
2Gazi University School of Medicine, Department of Neurosurgery, Ankara,
325 Aralık State Hospital, of NeurosurgeryDepartment , Gaziantep,
4Yeditepe University School of Medicine, Department of Neurosurgery, İstanbul,
5Ankara University School of Medicine, Department of Biostatistics, Ankara,
DOI: 10.5137/1019-5149.JTN.46194-23.2
Aim:We aimed to determine the clinical relevance of a rigid endoscopy surgical method for subdural hematomas 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.
Corresponding author : Fatih Yakar