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Erschienen in:
01.12.2014 | How I Do it - Neurosurgical Techniques
The minimally invasive endoscopic management of septated chronic subdural hematomas: surgical technique
Erschienen in: Acta Neurochirurgica | Ausgabe 12/2014
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Background
Fibrin membranes and compartmentalization within the subdural space are a frequent cause of failure in the treatment of chronic subdural hematomas (CSH). This specific subtype of CSH classically requires craniotomy, which carries significant morbidity and mortality rates, particularly in elderly patients. In this work, we describe a minimally invasive endoscopic alternative.
Methods
Under local scalp anesthesia, a rigid endoscope is inserted through a parietal burr hole in the subdural space to collapse fibrin septa and cut the internal membrane. It also allows cauterization of active bleedings and the placement of a drain under direct visualization.
Conclusions
The endoscopic treatment of septated CSH represents a minimally invasive alternative to craniotomy especially for the internal membranectomy.