Eyebrow Incision for Surgical Evacuation of a Lobar Intracerebral Hematoma with a Novel Endoport System.
10.7461/jcen.2017.19.2.101
- Author:
Dale DING
1
;
Colin J PRZYBYLOWSKI
;
Robert M STARKE
;
R Webster CROWLEY
;
Kenneth C LIU
Author Information
1. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. daleding1234@gmail.com
- Publication Type:Case Report
- Keywords:
Cerebral amyloid angiopathy;
Endoport;
Intracranial hemorrhages;
Microsurgery;
Minimally invasive;
Stroke
- MeSH:
Aged, 80 and over;
Catheterization;
Cerebral Amyloid Angiopathy;
Cerebral Hemorrhage;
Craniotomy;
Eyebrows*;
Female;
Follow-Up Studies;
Hematoma*;
Humans;
Intracranial Hemorrhages;
Microsurgery;
Skull Base;
Stroke
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2017;19(2):101-105
- CountryRepublic of Korea
- Language:English
-
Abstract:
Large lobar intracerebral hemorrhages (ICHs) can cause rapid neurological deterioration, and affected patients have low rates of survival and functional independence. Currently, the role of surgical intervention in the management patients with lobar ICHs is controversial. Minimally invasive technologies have been developed which may potentially decrease the operative morbidity of ICH surgery. The aim of this case report is to describe the technical aspects of the use of a novel minimally invasive endoport system, the BrainPath (NICO, Indianapolis, IN, USA), through an eyebrow incision for evacuation of a large lobar hematoma. An 84-year-old female presented with a left frontal ICH, measuring 7.5 cm in maximal diameter and 81 cm³ in volume, secondary to cerebral amyloid angiopathy. Through a left eyebrow incision, a miniature modified orbitozygomatic craniotomy was performed, which allowed endoport cannulation of the hematoma from a lateral subfrontal cortical entry point. Endoport-assisted hematoma evacuation resulted in nearly 90% volume reduction and improvement of the patient's functional status at clinical follow-up. We found that minimally invasive endoport technology can be employed in conjunction with conventional neurosurgical skull base principles to achieve safe and effective evacuation of large lobar hematomas in carefully selected patients.
