Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage

ABSTRACT Nowadays surgical treatment of patients with traumatic intracranial hematoma (TICH) and injuries of the brain is a very actual problem in neurosurgery.The purpose of this work was to assess of the feasibility and safety of minimally invasive endoscopic removal of TICH.MATERIAL AND METHODS I...

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Main Authors: I. M. Godkov, A. E. Talypov, V. V. Krylov, A. A. Grin, V. G. Dashyan, M. Yu. Savvin
Format: Article
Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2022-04-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/1336
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author I. M. Godkov
A. E. Talypov
V. V. Krylov
A. A. Grin
V. G. Dashyan
M. Yu. Savvin
author_facet I. M. Godkov
A. E. Talypov
V. V. Krylov
A. A. Grin
V. G. Dashyan
M. Yu. Savvin
author_sort I. M. Godkov
collection DOAJ
description ABSTRACT Nowadays surgical treatment of patients with traumatic intracranial hematoma (TICH) and injuries of the brain is a very actual problem in neurosurgery.The purpose of this work was to assess of the feasibility and safety of minimally invasive endoscopic removal of TICH.MATERIAL AND METHODS In the period of 2010–2019, 2734 operations were performed on patients with traumatic brain injury in the Sklifosovsky Research Institute. There were 334 patients with TICH and the CC/BC foci, that made 12.2% of all patients. The median of hematoma volume, that did not cause a loss of consciousness was 48 cm2, and in most of the patients the hematoma volume ranged 30–35 cm2. Local fibrinolysis of TICH was performed in 14 patients with the hematoma volume of 30–50 cm2 without brain dislocation and not causing the consciousness depression more severe than sopor.Endoscopic removal of TICH was performed in 4 men at mean age of 54.8 years within 18–36 hours after trauma. Three patients had depression of consciousness to obtundation (14 by Glasgow Outcome Scale (GCS)), and one patient was in clear consciousness. The volume of the dense part of the contusion foci in the pole-basal regions of the frontal and temporal lobes was 24–40 cm3.RESULTS Among patients with TICH operated on by using the traditional technique, postoperative lethality was 13%, good outcomes were seen in 41%, and 46% had neurological disorders of varying severity. While treating the patients with TICH by using the local fibrinolysis method, 1 patient died after surgery, a good outcome was seen in 8 of 14 patients, and neurological disorders persisted in 3 patients in the postoperative period.Radicality of surgery in patients operated on by using endoscopic technique averaged 76% ranging from 41% to 91%. There were no complications during surgery nor in post-operative period. Patients were discharged from hospital after 8-21 days.
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spelling doaj-art-08c57a6f71f84610bb5b7e68985d23ed2025-08-20T03:43:21ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172022-04-01111223010.23934/2223-9022-2022-11-1-22-30748Endoscopic Removal of Acute Traumatic Intracerebral HemorrhageI. M. Godkov0A. E. Talypov1V. V. Krylov2A. A. Grin3V. G. Dashyan4M. Yu. Savvin5N.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and DentistryN.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and DentistryN.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and DentistryN.V. Sklifosovsky Research Institute for Emergency MedicineABSTRACT Nowadays surgical treatment of patients with traumatic intracranial hematoma (TICH) and injuries of the brain is a very actual problem in neurosurgery.The purpose of this work was to assess of the feasibility and safety of minimally invasive endoscopic removal of TICH.MATERIAL AND METHODS In the period of 2010–2019, 2734 operations were performed on patients with traumatic brain injury in the Sklifosovsky Research Institute. There were 334 patients with TICH and the CC/BC foci, that made 12.2% of all patients. The median of hematoma volume, that did not cause a loss of consciousness was 48 cm2, and in most of the patients the hematoma volume ranged 30–35 cm2. Local fibrinolysis of TICH was performed in 14 patients with the hematoma volume of 30–50 cm2 without brain dislocation and not causing the consciousness depression more severe than sopor.Endoscopic removal of TICH was performed in 4 men at mean age of 54.8 years within 18–36 hours after trauma. Three patients had depression of consciousness to obtundation (14 by Glasgow Outcome Scale (GCS)), and one patient was in clear consciousness. The volume of the dense part of the contusion foci in the pole-basal regions of the frontal and temporal lobes was 24–40 cm3.RESULTS Among patients with TICH operated on by using the traditional technique, postoperative lethality was 13%, good outcomes were seen in 41%, and 46% had neurological disorders of varying severity. While treating the patients with TICH by using the local fibrinolysis method, 1 patient died after surgery, a good outcome was seen in 8 of 14 patients, and neurological disorders persisted in 3 patients in the postoperative period.Radicality of surgery in patients operated on by using endoscopic technique averaged 76% ranging from 41% to 91%. There were no complications during surgery nor in post-operative period. Patients were discharged from hospital after 8-21 days.https://www.jnmp.ru/jour/article/view/1336traumatic intracerebral hemorragecerebral contusionendoscopy
spellingShingle I. M. Godkov
A. E. Talypov
V. V. Krylov
A. A. Grin
V. G. Dashyan
M. Yu. Savvin
Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
Неотложная медицинская помощь
traumatic intracerebral hemorrage
cerebral contusion
endoscopy
title Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
title_full Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
title_fullStr Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
title_full_unstemmed Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
title_short Endoscopic Removal of Acute Traumatic Intracerebral Hemorrhage
title_sort endoscopic removal of acute traumatic intracerebral hemorrhage
topic traumatic intracerebral hemorrage
cerebral contusion
endoscopy
url https://www.jnmp.ru/jour/article/view/1336
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