{"title":"老年人硬膜下血肿治疗的变革:内窥镜病例系列的启示。","authors":"Mei-Cheng Hsiao, Yun-Yen Fu, Chi-Ruei Li, Chiung-Chyi Shen, Jenq-Ruey Lee, Cheng-Ying Lee","doi":"10.21873/invivo.13784","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Subdural hematoma (SDH), a critical brain condition, significantly affects the elderly, making traditional surgeries risky due to their length and potential for blood loss. Endoscope-assisted evacuation offers a safer, less invasive alternative by reducing operation time and minimizing damage, providing an effective solution for older patients. This study evaluated six patients treated with endoscopic evacuation for different stages of SDH from August 2019 to July 2023.</p><p><strong>Patients and methods: </strong>Selection criteria were based on altered consciousness, lack of severe brain contusion, SDH thickness over 1 cm, or midline shift over 0.5 cm. The technique used a burr hole and rigid lens endoscope for hematoma removal, focusing on shorter surgery times and better outcomes.</p><p><strong>Results: </strong>Patients aged between 63 to 84 years showed no surgical fatalities, with all recovering well by discharge. Hematoma clearance rates were 76.9% at three days, improving to 96.8% after one month.</p><p><strong>Conclusion: </strong>Endoscope-assisted evacuation is a safe, efficient treatment for elderly patients with various stages of SDH, offering a less invasive option with potential for better outcomes. It supports the trend towards minimally invasive neurosurgery, with further research needed to optimize patient selection and understand long-term benefits.</p>","PeriodicalId":13364,"journal":{"name":"In vivo","volume":"38 6","pages":"3011-3015"},"PeriodicalIF":1.8000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535949/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transforming Subdural Hematoma Treatment in the Elderly: Insights from an Endoscopic Case Series.\",\"authors\":\"Mei-Cheng Hsiao, Yun-Yen Fu, Chi-Ruei Li, Chiung-Chyi Shen, Jenq-Ruey Lee, Cheng-Ying Lee\",\"doi\":\"10.21873/invivo.13784\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>Subdural hematoma (SDH), a critical brain condition, significantly affects the elderly, making traditional surgeries risky due to their length and potential for blood loss. Endoscope-assisted evacuation offers a safer, less invasive alternative by reducing operation time and minimizing damage, providing an effective solution for older patients. This study evaluated six patients treated with endoscopic evacuation for different stages of SDH from August 2019 to July 2023.</p><p><strong>Patients and methods: </strong>Selection criteria were based on altered consciousness, lack of severe brain contusion, SDH thickness over 1 cm, or midline shift over 0.5 cm. The technique used a burr hole and rigid lens endoscope for hematoma removal, focusing on shorter surgery times and better outcomes.</p><p><strong>Results: </strong>Patients aged between 63 to 84 years showed no surgical fatalities, with all recovering well by discharge. Hematoma clearance rates were 76.9% at three days, improving to 96.8% after one month.</p><p><strong>Conclusion: </strong>Endoscope-assisted evacuation is a safe, efficient treatment for elderly patients with various stages of SDH, offering a less invasive option with potential for better outcomes. It supports the trend towards minimally invasive neurosurgery, with further research needed to optimize patient selection and understand long-term benefits.</p>\",\"PeriodicalId\":13364,\"journal\":{\"name\":\"In vivo\",\"volume\":\"38 6\",\"pages\":\"3011-3015\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535949/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"In vivo\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/invivo.13784\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"In vivo","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/invivo.13784","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Transforming Subdural Hematoma Treatment in the Elderly: Insights from an Endoscopic Case Series.
Background/aim: Subdural hematoma (SDH), a critical brain condition, significantly affects the elderly, making traditional surgeries risky due to their length and potential for blood loss. Endoscope-assisted evacuation offers a safer, less invasive alternative by reducing operation time and minimizing damage, providing an effective solution for older patients. This study evaluated six patients treated with endoscopic evacuation for different stages of SDH from August 2019 to July 2023.
Patients and methods: Selection criteria were based on altered consciousness, lack of severe brain contusion, SDH thickness over 1 cm, or midline shift over 0.5 cm. The technique used a burr hole and rigid lens endoscope for hematoma removal, focusing on shorter surgery times and better outcomes.
Results: Patients aged between 63 to 84 years showed no surgical fatalities, with all recovering well by discharge. Hematoma clearance rates were 76.9% at three days, improving to 96.8% after one month.
Conclusion: Endoscope-assisted evacuation is a safe, efficient treatment for elderly patients with various stages of SDH, offering a less invasive option with potential for better outcomes. It supports the trend towards minimally invasive neurosurgery, with further research needed to optimize patient selection and understand long-term benefits.
期刊介绍:
IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management.
The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.