Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion.
Jo Ee SamFuminari KomatsuYasuhiro YamadaRiki TanakaKento SasakiTakamitsu TamuraYoko KatoPublished in: Asian journal of neurosurgery (2024)
Introduction Acute subdural hematomas (ASDHs) have a high mortality rate and unfavorable outcomes especially in the elderly population even after surgery is performed. The conventional recommended surgeries by the Brain Trauma Foundation in 2006 were craniotomies or craniectomies for ASDH. As the world population ages, and endoscopic techniques improve, endoscopic surgery should be utilized to improve the outcomes in elderly patients with ASDH. Materials and Methods This was a single-center retrospective report on our series of six patients that underwent endoscopic ASDH evacuation (EASE). Demographic data, the contralateral global cortical atrophy (GCA) score, evacuation rates, and outcomes were analyzed. Results All patients' symptoms and Glasgow Coma Scale improved or were similar after EASE with no complications. Good outcome was seen in 4 (66.7%) patients. Patients with poor outcome had initial low Glasgow Coma Scale scores on admission. The higher the contralateral GCA score, the higher the evacuation rate ( r = 0.825, p ≤ 0.043). All the patients had a GCA score of ≥7. Conclusion EASE is at least not inferior to craniotomy for the elderly population in terms of functional outcome for now. Using the contralateral GCA score may help identify suitable patients for this technique instead of just using a cut-off age as a criteria.
Keyphrases
- end stage renal disease
- chronic kidney disease
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- cardiovascular disease
- patient reported outcomes
- liver failure
- minimally invasive
- risk factors
- coronary artery disease
- acute coronary syndrome
- ultrasound guided
- adipose tissue
- artificial intelligence
- cross sectional
- patient reported
- skeletal muscle
- middle aged
- white matter
- acute respiratory distress syndrome
- community dwelling
- respiratory failure
- functional connectivity
- resting state
- cerebral ischemia