Han Kaiwei, Li Yiming, Zhao Liang, Zhao Yuqing, Hou Lijun, Evins Alexander I, Xu Tao
Department of Neurosurgery, Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA.
J Ultrasound. 2024 Aug 5. doi: 10.1007/s40477-024-00943-3.
Intracerebral hemorrhage (ICH) is a common neurosurgical emergency that is associated with high morbidity and mortality. Minimally invasive or endoscopic hematoma evacuation has emerged in recent years as a viable alternative to conventional large craniotomies. However, accurate trajectory planning and placement of the tubular retractor remains a challenge. We describe a novel technique for handheld portable ultrasound-guided minimally invasive endoscopic evacuation of supratentorial hematomas. A 64-year-old male diagnosed right hematoma (48.5 mL) at the basal ganglia was treated with emergent ultrasound-guided endoscopic transtubular evacuation through a small craniotomy. Ultrasound-guidance facilitated optimal placement of the tubular retractor into the long axis of the hematoma, and allowed for near-total evacuation, reducing iatrogenic tissue damage by mitigating the need for wanding or repositioning of the retractor. The emergence of a new generation of small portable phased array ultrasound probes with improved resolution and clarity has broadened ultrasound's clinical applications.
脑出血（ICH）是一种常见的神经外科急症，具有高发病率和死亡率。近年来，微创或内镜下血肿清除术已成为传统大骨瓣开颅术的可行替代方案。然而，精确的轨迹规划和管状牵开器的放置仍然是一项挑战。我们描述了一种用于手持式便携式超声引导下幕上血肿微创内镜清除的新技术。一名64岁男性被诊断为基底节区右侧血肿（48.5 mL），通过小骨窗开颅术进行了急诊超声引导下内镜经管状清除术。超声引导有助于将管状牵开器最佳地放置在血肿的长轴上，并实现近乎完全清除，通过减少牵开器的盲目操作或重新定位需求，减少了医源性组织损伤。新一代具有更高分辨率和清晰度的小型便携式相控阵超声探头的出现拓宽了超声的临床应用。
