Turkish Neurosurgery 2024 , Vol 34 , Num 6
Nonacute Subdural Hematoma Evacuation Using a Rigid Endoscopy System: A Clinical Study
Emrah EGEMEN1,Umit Akin DERE1,Emrah CELTIKCI2,Ali NEHIR3,Yucel DOGRUEL4,Defne SAHINOGLU1,Rasim ASAR1,Batuhan BAKIRARAR5,Baris ALBUZ1,Mehmet Erdal COSKUN1,Fatih YAKAR1
1Pamukkale University School of Medicine, Department of Neurosurgery, Denizli, Türkiye
2Gazi University School of Medicine, Department of Neurosurgery, Ankara, Türkiye
325 Aralık State Hospital, Department of Neurosurgery, Gaziantep, Türkiye
4Yeditepe University School of Medicine, Department of Neurosurgery, Istanbul, Türkiye
5Ankara University School of Medicine, Department of Biostatistics, Ankara, Türkiye
DOI : 10.5137/1019-5149.JTN.46194-23.2 AIM: To determine the clinical relevance of a rigid endoscopy surgical method for subdural hematomas, as 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. Keywords : Subdural, Endoscopy, Hematoma, Minimally invasive

Corresponding author : Fatih YAKAR, yakarneurosurgery@gmail.com