Endoscopic surgery to chronic subdural hematoma with neovessel septation: technical notes and literature review

Objective and importance: We report Septated Chronic Subdural Hematoma (sCSDH) cases with the neovessel in the hematoma cavity, and evaluate surgical effect of the neuroendoscope-assisted neovessel coagulation for these sCSDH patients. Clinical presentation: Four patients suffered from sCSDH with di...

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Bibliographic Details
Published in:Neurological research (New York) 2016-05, Vol.38 (5), p.467-476
Main Authors: Yan, Kaixuan, Gao, Heng, Wang, Qipin, Xu, Xiangdong, Wu, Wei, Zhou, Xinmin, Xu, Weidong, Ye, Fuhua
Format: Article
Language:English
Subjects:
Aged
Databases, Bibliographic - statistics & numerical data
Endoscopy - instrumentation
Endoscopy - methods
Female
Hematoma, Subdural, Chronic - diagnostic imaging
Hematoma, Subdural, Chronic - surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neovessel
Neuroendoscope
Recovery of Function - physiology
Septated chronic subdural hematoma
Surgery
Tomography, X-Ray Computed
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Summary:Objective and importance: We report Septated Chronic Subdural Hematoma (sCSDH) cases with the neovessel in the hematoma cavity, and evaluate surgical effect of the neuroendoscope-assisted neovessel coagulation for these sCSDH patients. Clinical presentation: Four patients suffered from sCSDH with different clinical symptoms. Magnetic resonance imaging (MRI) was applied to differentiate the neovessel from the bridge vein and septa fibra. Endoscopic surgeries were performed after their admission. Technique: Through the small bone window, we used suction to clean the surgical field so that the neovessels can be exposed, which is thought to be the one of recurrence factors for the sCSDH, then we coagulated and cut them under the neuroendoscope. Case examples are described here to illustrate the technique. Conclusion: This report illustrates that the neovessel is one of recurrence factors of sCSDH and has special characteristics showed on MRI. Through this technique with the guidance of MRI the recurrence rate of sCSDH can be reduced.
ISSN:0161-6412
1743-1328
DOI:10.1080/01616412.2016.1139772