Endoscopic hematoma evacuation through dilated burr hole for acute subdural hematoma in elderly patients_ Feasibility of endoscopic procedure and its technical tips as less invasive surgery

Abstract

Object: We describe results of endoscopic surgery for acute subdural hematoma in elderly patients, and simple technique of the endoscopic procedure for acute subdural hematoma (ASDH) through an extended burr hole in elderly patients and discuss its technical aspects. Methods: We performed endoscopic evacuation of acute subdural hematoma in selected fifteen elderly patients. The following data were collected and evaluated: age, sex, laterality, administration of anti-thrombotic agents, injury severity score (ISS), pre and post-operative GCS, modified Rankin scale (mRS) before and post-treatment of ASDH, type of anesthesia, operation time, origin of bleeding. Results: Postoperatively, satisfactory hematoma evacuation was accomplished. No hemorrhagic adverse effects related with endoscopic procedure were observed. Postoperative GCS was improved in all patients, and three patients were discharged with mRS 0–2 consistent with independent gait. Conclusion: Endoscopic evacuation of acute subdural hematoma for elderly patient is a less invasive treatment and might be technically feasible in selected cases.

Keywords

• Acute subdural hematoma
• Endoscopic surgery
• Dilated burr hole
• Elderly