Endoscopic-assisted evacuation of chronic subdural hematomas - A retrospective analysis and a literature review.
- 1Cellular Signaling Laboratory, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna-Alma Mater Studiorum, Bologna, Italy.
- 2Department of Neurosurgery, Regional Hospital San Carlo, Potenza, Italy.
- 3Department of Neuroradiology, Regional Hospital San Carlo, Potenza, Italy.
Abstract
Background
Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in elderly patients. Burr-hole craniectomy (BHC) remains the standard treatment; however, endoscopic-assisted (EA) techniques have been increasingly adopted to improve visualization of the subdural space, facilitate membranectomy, and enhance hemostasis. We report a single-center retrospective comparison between BHC and EA for CSDH evacuation and review the current literature on the role of endoscopy in this setting.Methods
Patients undergoing surgical evacuation of CSDH over a 1-year period were retrospectively analyzed. All procedures were performed by a single surgeon. Patients were divided into BHC and EA groups. Demographic, clinical, radiological, and operative variables, as well as postoperative outcomes, were compared. A systematic literature review was also conducted.Results
Twenty-one patients were included (14 BHC, 7 EA). All EA cases presented with organized hematomas and membranes on preoperative imaging. Mean operative time for EA was 62.5 min, and no drains were used. EA provided circumferential visualization of the subdural cavity, allowing targeted membranectomy and precise hemostasis. Patients in the EA group demonstrated significant postoperative functional improvement and pain reduction, with no recurrences or complications observed. Radiological resolution was slower compared to BHC. Literature review showed that 15 of 16 studies favored endoscopic assistance, particularly for organized or septated hematomas.Conclusion
EA evacuation appears safe and effective in selected CSDHs with organized membranes. Direct visualization of the subdural space may improve surgical control and potentially reduce recurrence risk.
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BibTeX
@article{gelmi2026endoscopicassisted,
title = {{Endoscopic-assisted evacuation of chronic subdural hematomas - A retrospective analysis and a literature review.}},
author = {Clarissa Ann Elisabeth Gelmi and Giulio Cecchini and Valeria Coppola and Stefano Ratti and Francesco Di Biase},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_226_2026},
url = {https://europepmc.org/article/MED/42974544},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Endoscopic-assisted evacuation of chronic subdural hematomas - A retrospective analysis and a literature review.
AU - Clarissa Ann Elisabeth Gelmi
AU - Giulio Cecchini
AU - Valeria Coppola
AU - Stefano Ratti
AU - Francesco Di Biase
PY - 2026
DA - 2026/10/02
JO - Surgical neurology international
DO - 10.25259/sni_226_2026
UR - https://europepmc.org/article/MED/42974544
AB - Background Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in elderly patients. Burr-hole craniectomy (BHC) remains the standard treatment; however, endoscopic-assisted (EA) techniques have been increasingly adopted to improve visualization of the subdural space, facilitate membranectomy, and enhance hemostasis. We report a single-center retrospective comparison between BHC and EA for CSDH evacuation and review the current literature on the role of endoscopy in this setting.Methods Patients undergoing surgical evacuation of CSDH over a 1-year period were retrospectively analyzed. All procedures were performed by a single surgeon. Patients were divided into BHC and EA groups. Demographic, clinical, radiological, and operative variables, as well as postoperative outcomes, were compared. A systematic literature review was also conducted.Results Twenty-one patients were included (14 BHC, 7 EA). All EA cases presented with organized hematomas and membranes on preoperative imaging. Mean operative time for EA was 62.5 min, and no drains were used. EA provided circumferential visualization of the subdural cavity, allowing targeted membranectomy and precise hemostasis. Patients in the EA group demonstrated significant postoperative functional improvement and pain reduction, with no recurrences or complications observed. Radiological resolution was slower compared to BHC. Literature review showed that 15 of 16 studies favored endoscopic assistance, particularly for organized or septated hematomas.Conclusion EA evacuation appears safe and effective in selected CSDHs with organized membranes. Direct visualization of the subdural space may improve surgical control and potentially reduce recurrence risk.
SN - 2229-5097
SN - 2152-7806
ER -