Clinical effectiveness of neuroendoscopic evacuation for chronic subdural hematoma

Zhang Bo; Zhao Jiawei; Chen Xueyong; Liu Feng

doi:10.11850/j.issn.1009-122X.2024.12.003

Abstract：Objective To explore the application value of neuroendoscopic hematoma evacuation in the treatment of chronic subdural hematoma(CSDH).Methods The clinical data of 67 patients with CSDH were analyzed retrospectively.The control group(n=35)underwent burr hole craniostomy and drainage,while the treatment group(n=32)underwent neuroendoscopic CSDH evacuation.Comparisons were made between the two groups in terms of hematoma evacuation rate,recurrence rate,complications,intracranial pressure score(Markwalder score),motor function score(Fugl-Meyer Assessment,FMA),and activities of daily living(ADL)score at 3 months postoperatively.Results The hematoma evacuation rate 1 day after surgery in the treatment group was higher than that in the control group,the average duration of drainage tube retention and average length of hospital stay were shorter in the treatment group than in the control group,with statistically significant differences(all P<0.05).The Markwalder score,FMA score,and ADL score were better in the treatment group than in the control group(P<0.05).There were no postoperative complications in the treatment group,while 7 cases of postoperative complications occurred in the control group,with statistically significant differences between the two groups(P<0.05).During the 3-month follow-up,2 cases(6.25%,2/32)of recurrence were observed in the treatment group,and 6 cases(17.14%,6/35)in the control group,with statistically significant differences in postoperative recurrence rates between the two groups(P<0.05).Conclusions Neuroendoscopic technology allows for direct visualization and effective hematoma evacuation within the hematoma cavity,reducing the postoperative recurrence rate.Neuroendoscopic hematoma evacuation is a safe and effective treatment for CSDH.