Background: Standard surgical treatment for traumatic intracranial hemorrhage such as acute subdural hematoma and brain contusion is craniotomy or craniectomy with general anesthesia. However, we offen hesitate surgery for patients who have severe general state or elderly. For these patients, endoscopic surgery is performed in our hospital. In this study, we investigated cases of traumatic intracranial hemorrhage treated with endoscopic surgery and its surgical results retrospectively.
Methods: Thirteen patients with traumatic intracranial hemorrhage were admitted to our hospital and treated with endoscopic surgery from April 2008 to August 2015. Nine patients with brain contusion and 4 patients with acute subdural hematoma was included. We investigated following factor: age, sex, pre-operative consciousness, hematoma volume and thickness, evacuation rate of hematoma, complication and modified Rankin Scale (mRS) at discharge.
Results: All cases were treated with endoscopic surgery only without decompressive craniectomy. In cases of brain contusion, mRS at discharge was 0–2: 4 cases (44%), 3–5: 3 cases (33%), 6: 2 cases (22%). In cases of mRS 6, cause of mortality was myocardial infarction and sepsis, respectively, and no case died of brain trauma. In cases of acute subdural hematoma, mRS at discharge was, 3–5: 3 cases (75%), 6: 1 case (25%). Cause of mortality was rebleeding.
Conclusion: Endoscopic surgery for traumatic intracranial hemorrhage is a treatment option if its indication is considered carefully. While it is not sufficient for hemostasis, endoscopic surgery is less invasive and possible to perform sufficient decrease of intracranial pressure compared with craniotomy or craniectomy. The number of endoscopic surgery for traumatic intracranial hemorrhage is still small, further studies are needed.