Minimally Invasive Endoscopy for Acute Subdural Hematomas: A Report of 3 Cases.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Khattar, NK; McCallum, AP; Fortuny, EM; White, AC; Ball, TJ; Adams, SW; Meyer, KS; Wei, G; John, KD; Bak, E; Sieg, EP; Ding, D; James, RF

Published Date

  • February 16, 2021

Published In

Volume / Issue

  • 20 / 3

Start / End Page

  • 310 - 316

PubMed ID

  • 33372226

Electronic International Standard Serial Number (EISSN)

  • 2332-4260

Digital Object Identifier (DOI)

  • 10.1093/ons/opaa390


  • eng

Conference Location

  • United States