TITLE:
Endoscopic Assisted Microscopic Fenestration of Inner Membrane in Cases of Chronic Subdural Hematoma
AUTHORS:
Mohamed Gaber Abdel Tawab, Mohamed Reda, Ahmed El-Fiki
KEYWORDS:
Endoscopic Assisted Microscopic, Chronic Subdural Hematoma (CSDH), Membranectomy, Fenestration
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.9 No.2,
April
28,
2019
ABSTRACT: Introduction: Chronic subdural hematoma (CSDH) is one of the most common types of intracranial hemorrhages and carries a significant morbidity; there is no clear optimal treatment. Recurrence, pneumocephaly and seizures are common complications. We will evaluate outcome after inner membrane fenestration in comparison to burr-hole evacuation only in cases of CSDH. Patients and Methods: Our work was conducted on 20 patients with CSDH from February 2017 to July 2017. Endoscopic-assisted microscopic fenestration technique was used to do inner membrane fenestration in ten patients and the other 10 patients operated upon by traditional burr-hole evacuation. Regular follow up was done up to one month. Results: Clinical outcome was nearly the same in the two groups. Recurrence rate was only noted in the non-fenestration group (20%). Midline shift was better in the membrane fenestration group after one month and we experienced no intraoperative surgical complications related to the fenestration technique. Postoperative complications, such as Pneumocephalus and seizures, were seen in both study groups. Conclusion: Endoscopic assisted microscopic technique decreases surgical risks to do inner membrane fenestration although there is no major difference between doing fenestration or not in clinical outcome, but it may decrease recurrence, but larger studies are needed.