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内镜辅助下外伤性脑出血清除术:病例报告及技术要点

Endoscopic-assisted removal of traumatic brain hemorrhage: case report and technical note.

作者信息

Nascimento Clarissa Nóbrega Gambarra, Amorim Robson Luis, Mandel Maurício, do Espírito Santo Marcelo Prudente, Paiva Wellingson Silva, Andrade Almir Ferreira, Teixeira Manoel Jacobsen

机构信息

Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil

Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.

出版信息

J Surg Case Rep. 2015 Nov 3;2015(11):rjv132. doi: 10.1093/jscr/rjv132.

Abstract

The endoscopic technique has been described as a minimally invasive method for spontaneous hematoma evacuation, as a safe and effective treatment. Nevertheless, to our knowledge, there is no description of a technical report of traumatic intracerebral hematoma removal using the neuroendoscope. A 47-year-old man was admitted sustaining 13 points in Glasgow coma scale with brain computed tomography (CT) scan showing a temporal contusion. Guided by a 3D reconstructed CT, using the program OsiriX®, the posterior limit of the hematoma was identified. A burr hole was placed at the posterior temporal region, and we used the neuroendoscope to assist the hematoma evacuation. The postoperative tomography showed adequate hematoma removal. He was discharged from hospital 48 h after surgery. Two weeks later, he was conscious and oriented temporally. This endoscopic-assisted technique can provide safe removal of traumatic hematomas of the temporal lobe.

摘要

内镜技术已被描述为一种用于自发性血肿清除的微创方法,是一种安全有效的治疗方法。然而,据我们所知,尚无使用神经内镜清除创伤性脑内血肿的技术报告。一名47岁男性因格拉斯哥昏迷评分为13分入院,脑部计算机断层扫描(CT)显示颞叶挫伤。在三维重建CT的引导下,使用OsiriX®程序,确定了血肿的后界。在颞叶后部区域钻了一个骨孔,我们使用神经内镜辅助血肿清除。术后CT显示血肿清除充分。术后48小时他出院了。两周后,他意识清醒,时间定向正常。这种内镜辅助技术可以安全地清除颞叶创伤性血肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1c7/4631953/3df91b18afaa/rjv13201.jpg

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