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The minimally invasive endoscopic management of septated chronic subdural hematomas: surgical technique

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Abstract

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.

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Conflicts of interest

None.

Financial disclosure

None.

Authors’ contributions

Conception and design: MB; Acquisition of data: MB; Analysis and interpretation of data: MB, EJ; Drafting: MB; Critically revising the article: MB, EJ, MM; Study supervision: MB, EJ.

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Authors and Affiliations

  1. Minimally Invasive and Endoscopic Neurosurgery Program, Pierre Wertheimer Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, 69500, France

    M. Berhouma, T. Jacquesson & E. Jouanneau

  2. Faculty of Medicine, Claude Bernard University, Lyon, France

    T. Jacquesson & E. Jouanneau

  3. INSERM U1028, CNRS UMR5292, Neurosciences Research Center of Lyon, Neuro-oncology and Neuro-inflammation team, Lyon, France

    E. Jouanneau

Authors
  1. M. Berhouma
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  2. T. Jacquesson
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  3. E. Jouanneau
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Corresponding author

Correspondence to M. Berhouma.

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Berhouma, M., Jacquesson, T. & Jouanneau, E. The minimally invasive endoscopic management of septated chronic subdural hematomas: surgical technique. Acta Neurochir 156, 2359–2362 (2014). https://doi.org/10.1007/s00701-014-2219-1

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  • DOI: https://doi.org/10.1007/s00701-014-2219-1

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