ArticleActa neurochirurgica2020
Intraoperative CT and cone-beam CT imaging for minimally invasive evacuation of spontaneous intracerebral hemorrhage.
Article in Acta neurochirurgica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 20 citations in OpenAlex.
- Beyond the bone flap: integrating biomarkers, imaging, and emerging technologies in the surgical continuum of acute subdural hematoma (ASDH).Annals of medicine and surgery (2012) · 2026Review
- Application of individualized localization technology based on multimodal image spatial coordinate mapping in suboccipital retrosigmoid approach surgery.Frontiers in neurology · 2026Article
- Intraoperative cone-beam CT for real-time quality control in CSF shunt surgery: a prospective workflow study.Brain & spine · 2026Article
- The efficacy of robot-assisted surgery on minor basal ganglia cerebral hemorrhage with neurological dysfunction.Neurosurgical review · 2024Article
- IV Flat Detector CT Angiography in Flat Detector CT Image-Guided Minimally Invasive Surgery for the Treatment of Intracerebral Hypertensive Hemorrhage.AJNR. American journal of neuroradiology · 2024Article
- Identifying Predictors of Initial Surgical Failure during Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation.Biomedicines · 2024Article
- Review
- Endoscopic Cerebellar Necrosectomy for Space-occupying Cerebellar Infarction: A Case Report.NMC case report journal · 2024Article
- Should individual timeline and serial CT/MRI panels of all patients be presented in acute brain insult cohorts? A pilot study of 45 patients with decompressive craniectomy after aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2023Review
- Use of Dyna-computed tomography-assisted neuroendoscopic hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage.Neurosurgical review · 2023Article
- Surgical Robotics for Intracerebral Hemorrhage Treatment: State of the Art and Future Directions.Annals of biomedical engineering · 2023Review
- Combining physics-based models with deep learning image synthesis and uncertainty in intraoperative cone-beam CT of the brain.Medical physics · 2023Article
- How to iGuide: flat panel detector, CT-assisted, minimally invasive evacuation of intracranial hematomas.Journal of neurointerventional surgery · 2022Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMinimally invasive surgery (MIS) for evacuation of spontaneous intracerebral hemorrhage (ICH) has shown promise but there remains a need for intraoperative performance assessment considering the wide range of evacuation effectiveness. In this feasibility study, we analyzed the benefit of intraoperative 3-dimensional imaging during navigated endoscopy-assisted ICH evacuation by mechanical clot fragmentation and aspiration.
methods18 patients with superficial or deep supratentorial ICH underwent MIS for clot evacuation followed by intraoperative computerized tomography (iCT) or cone-beam CT (CBCT) imaging. Eligibility for MIS required (a) availability of intraoperative iCT or CBCT, (b) spontaneous lobar or deep ICH without vascular pathology, (c) a stable ICH volume (20-90 ml), (d) a reduced level of consciousness (GCS 5-14), and (e) a premorbid mRS ≤ 1. Demographic, clinical, and radiographic patient data were analyzed by two independent observers.
resultsNine female and 9 male patients with a median age of 76 years (42-85) presented with an ICH score of 3 (1-4), GCS of 10 (5-14) and ICH volume of 54 ± 26 ml. Clot fragmentation and aspiration was feasible in all cases and intraoperative imaging determined an overall evacuation rate of 80 ± 19% (residual hematoma volume: 13 ± 17 ml; p < 0.0001 vs. Pre-OP). Based on the intraoperative imaging results, 1/3rd of all patients underwent an immediate re-aspiration attempt. No patient experienced hemorrhagic complications or required conversion to open craniotomy. However, routine postoperative CT imaging revealed early hematoma re-expansion with an adjusted evacuation rate of 59 ± 30% (residual hematoma volume: 26 ± 37 ml; p < 0.001 vs. Pre-OP).
conclusionsRoutine utilization of iCT or CBCT imaging in MIS for ICH permits direct surgical performance assessment and the chance for immediate re-aspiration, which may optimize targeting of an ideal residual hematoma volume and reduce secondary revision rates.
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