دورية أكاديمية

Application of neuro-endoscopic target aspiration of the necrotic core for cerebral contusion with delayed progression: technical note.

التفاصيل البيبلوغرافية
العنوان: Application of neuro-endoscopic target aspiration of the necrotic core for cerebral contusion with delayed progression: technical note.
المؤلفون: Mino, Masaki, Fujimura, Miki, Yoshida, Masahiro, Sonobe, Shinya, Tominaga, Teiji
المصدر: Acta Neurochirurgica; Feb2019, Vol. 161 Issue 2, p225-230, 6p, 1 Color Photograph, 2 Black and White Photographs, 1 Diagram, 1 Chart
مصطلحات موضوعية: CRANIOTOMY, MEDICAL suction, BRAIN injuries, BRUISES
مستخلص: Background: The optimal management strategy for cerebral contusion remains controversial, especially when standard craniotomy could not be used. We performed neuro-endoscopic target lesionectomy for the delayed progression of cerebral contusion in order to aspirate the necrotic core, which is the primal source of contusional edema.Methods: The present study included 10 consecutive patients (2 women and 8 men, with a mean age of 67 years old) with traumatic brain injury presenting with delayed deterioration of cerebral contusion where standard craniotomy could not be used. Neuro-endoscopic aspiration of the necrotic core was prospectively performed for all patients. We assessed the computed tomography findings after surgery to evaluate the efficacy of this procedure.Results: Endoscopic surgery was performed promptly after neurological deterioration, with a mean interval between trauma and surgery of 7 days, ranging from 2 to 16 days. During the operation, the centers of contusions comprised serous liquid components in all 10 patients and were easily aspirated by endoscopy. Contusional edemas were markedly decreased in all within 3 days after surgery.Conclusions: Progression of contusional edema can be caused by the accumulation of water into the necrotic core due to the rapid increase in osmolality. In light of the highly liquefied demarcated characteristics of the necrotic core, neuro-endoscopic aspiration could be an optional treatment strategy for cerebral contusion with delayed progression in a minimally invasive manner. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:00016268
DOI:10.1007/s00701-018-3753-z