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Lin Z, Lin F, Jiang Z, Lin Y. Letter to the Editor Regarding "Clinical Characteristics and Surgical Outcomes of Super-Elderly Patients with Chronic Subdural Hematoma". World Neurosurg 2023; 176:248. [PMID: 37550926 DOI: 10.1016/j.wneu.2023.04.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Zhiqin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China; Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
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Liu T, Gao Z, Zhou J, Lai X, Chen X, Rao Q, Guo D, Zheng J, Lin F, Lin Y, Lin Z. Subdural evacuating port system with subdural thrombolysis for the treatment of chronic subdural hematoma in patients older than 80 years. Front Neurol 2023; 14:1068829. [PMID: 36873430 PMCID: PMC9975157 DOI: 10.3389/fneur.2023.1068829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023] Open
Abstract
Objective The subdural evacuating port system (SEPS) is a minimally invasive approach that can be performed under local anesthesia for the treatment of chronic subdural hematoma (CSDH). Subdural thrombolysis has been described as an exhaustive drainage strategy and found to be safe and effective for improving drainage. We aim to analyze the effectiveness of SEPS with subdural thrombolysis in patients older than 80 years. Method Consecutive patients aged ≥80 years old who presented with symptomatic CSDH and underwent SEPS followed by subdural thrombolysis between January 2014 and February 2021 were retrospectively studied. Outcome measures included complications, mortality, recurrence, and modified Rankin Scale (mRS) scores at discharge and 3 months. Results In total, 52 patients with CSDH in 57 hemispheres were operated on, with a mean age of 83.9 ± 3.3 years, and 40 (76.9%) patients were men. The preexisting medical comorbidities were observed in 39 patients (75.0%). Postoperative complications occurred in nine patients (17.3%), with two having significant complications (3.8%). The complications observed included pneumonia (11.5%), acute epidural hematoma (3.8%), and ischemic stroke (3.8%). One patient experienced contralateral malignant middle cerebral artery infarction and died of subsequent severe herniation, contributing to a perioperative mortality rate of 1.9%. Discharge and 3 months of favorable outcomes (mRS score 0-3) were achieved in 86.5% and 92.3% of patients, respectively. CSDH recurrence was observed in five patients (9.6%), and repeat SEPS was performed. Conclusion As an exhaustive drainage strategy, SEPS followed by thrombolysis is safe and effective with excellent outcomes among elderly patients. It is a technically easy and less invasive procedure with similar complications, mortality, and recurrence rates compared with burr-hole drainage in the literature.
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Affiliation(s)
- Tianqing Liu
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Zhenwen Gao
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Jianjun Zhou
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Xiaoyan Lai
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Xiaomei Chen
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Qiong Rao
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Dongbin Guo
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Jinliang Zheng
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zhiqin Lin
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.,Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Xu M, Tan W, Wang W, Wang D, Zeng W, Wang C. Minimally Invasive Surgery in Chronic Subdural Hematoma: Prognosis and Recurrence Factors of 516 Cases in a Single Center. J Clin Med 2022; 11:1321. [PMID: 35268412 PMCID: PMC8911056 DOI: 10.3390/jcm11051321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Abstract
Objective: To investigate the effects of minimally invasive surgery (MIS) using a novel YL-1 puncture needle and summarize the risk factors of recurrence in chronic subdural hematoma (CSDH). Methods: We performed a retrospective analysis in 516 hospitalized patients with CSDH from January 2013 to December 2018 in Northern Jiangsu People’s Hospital. Patients’ gender, age, history of trauma, use of anticoagulants, history of disturbed liver or renal function, history of heart disease, history of malignant tumor, history of diabetes, hemodialysis, coagulopathy, alcoholism, imaging indicators, and postoperative application of urokinase or atorvastatin were recorded. Recurrence is defined by imaging examination with or without clinical presentation three months after discharge. Results: In total, 483 patients (93.60%) benefited from MIS by YL-1 needle. Gender, age, history of head trauma, history of disturbed liver function, history of heart disease, history of malignant tumor, history of diabetes, history of hemodialysis, coagulopathy, alcoholism, hematoma location, hematoma densities, septum formation, maximum thickness, encephalatrophy, and use of atorvastatin and urokinase were shown to be non-significantly associated with postoperative recurrence (p > 0.05). The use of anticoagulants was significantly associated with postoperative recurrence (p > 0. 05). Logistic analysis showed that the use of anticoagulants is an independent factor predicting postoperative recurrence (p > 0. 05). Conclusions: The novel YL-1 puncture needle turned out to be a safe and effective minimally invasive surgery, and the use of anticoagulants is an independent risk factor predicting postoperative recurrence in CSDH, which can provide MIS and early therapeutic strategies for neurosurgeons.
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Affiliation(s)
- Min Xu
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine (Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine), Kunshan 215300, China; (M.X.); (W.T.); (W.W.)
| | - Weiguo Tan
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine (Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine), Kunshan 215300, China; (M.X.); (W.T.); (W.W.)
| | - Wenhua Wang
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine (Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine), Kunshan 215300, China; (M.X.); (W.T.); (W.W.)
| | - Dongdong Wang
- Department of Neurosurgery, Northern Jiangsu People’s Hospital, Yangzhou 225001, China; (D.W.); (W.Z.)
| | - Wei Zeng
- Department of Neurosurgery, Northern Jiangsu People’s Hospital, Yangzhou 225001, China; (D.W.); (W.Z.)
| | - Cunzu Wang
- Department of Neurosurgery, Northern Jiangsu People’s Hospital, Yangzhou 225001, China; (D.W.); (W.Z.)
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Zhao N, Lin Q, Yao K, Zhang F, Tian B, Chen F, Jiang Z. Simultaneous Measurement of Temperature and Refractive Index Using High Temperature Resistant Pure Quartz Grating Based on Femtosecond Laser and HF Etching. MATERIALS 2021; 14:ma14041028. [PMID: 33671573 PMCID: PMC7926831 DOI: 10.3390/ma14041028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
The optical fiber temperature and refractive index sensor combined with the hollow needle structure for medical treatment can promote the standardization of traditional acupuncture techniques and improve the accuracy of body fluid analysis. A double-parameter sensor based on fiber Bragg grating (FBG) is developed in this paper. The sensor materials are selected through X-ray diffraction (XRD) analysis, and the sensor sensing principle is theoretically analyzed and simulated. Through femtosecond laser writing pure silica fiber, a high temperature resistant wavelength type FBG temperature sensor is obtained, and the FBG is corroded by hydrofluoric acid (HF) to realize a high-sensitivity intensity-type refractive index sensor. Because the light has dual characteristics of energy and wavelength, the sensor can realize simultaneous dual-parameter sensing. The light from the lead-in optical fiber is transmitted to the sensor and affected by temperature and refractive-index; then, the reflection peak is reflected back to the lead-out fiber by the FBG. The high temperature response and the refractive index response of the sensor were measured in the laboratory, and the high temperature characteristics of the sensor were verified in the accredited institute. It is demonstrated that the proposed sensor can achieve temperature sensing up to 1150 °C with the sensitivity of 0.0134 nm/°C, and refractive sensing over a refractive range of 1.333 to 1.4027 with the sensitivity of -49.044 dBm/RIU. The sensor features the advantages of two-parameter measurement, compact structure, and wide temperature range, and it exhibits great potential in acupuncture treatment.
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Affiliation(s)
- Na Zhao
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
| | - Qijing Lin
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
- Collaborative Innovation Center of High-End Manufacturing Equipment, Xi’an Jiaotong University, Xi’an 710054, China
- Correspondence:
| | - Kun Yao
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
| | - Fuzheng Zhang
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
| | - Bian Tian
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
| | - Feng Chen
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
| | - Zhuangde Jiang
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710049, China; (N.Z.); (K.Y.); (F.Z.); (B.T.); (F.C.); (Z.J.)
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Wang D, Wang H, Xu M, Chen P, Yu B, Wen J, Zhang H, Zeng W, He S, Wang C. The effect of atorvastatin on recurrence of chronic subdural hematoma after novel YL-1 puncture needle surgery. Clin Neurol Neurosurg 2021; 202:106548. [PMID: 33609954 DOI: 10.1016/j.clineuro.2021.106548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Chronic subdural hematoma (CSDH) is a common neurological disorder with a high recurrence rate. This study investigates the effect that atorvastatin has when used as a postoperative adjuvant therapy on the prevention of CSDH recurrence after YL-1 puncture needle surgery. PATIENTS AND METHODS A retrospective analysis of 516 CSDH patients who underwent YL-1 puncture needle surgery was undertaken. Baseline characteristics including sex, age, history of injury, past medical histories (anticoagulation, liver dysfunction, heart diseases, malignant tumors, diabetes, hemodialysis, and chronic alcoholism), and computed tomography (CT) or magnetic resonance imaging (MRI) diagnostic indicators (bilateral, mixed density or signal, maximum hematoma width, and brain atrophy) were recorded. Differences in recurrence rates were compared between two groups: one with atorvastatin after surgery and one without. RESULTS 516 patients (429 men and 87 women), aged 14-98 years (mean age, 67.09 ± 11.74 years) were included in the study. YL-1 puncture needle surgery was performed 610 times. 94 patients had bilateral surgery, totaling 184 procedures. 301 patients with 360 procedures were treated with atorvastatin after surgery, of which 25 had recurrent CSDH; recurrence rate: 7.0 % (25/360). 215 patients with 250 procedures had surgery without subsequent atorvastatin, of which 14 had recurrent CSDH; recurrence rate: 5.6 % (14/250). Univariate analysis indicated no statistically significant difference in recurrence rates between groups (P > 0.05). Baseline characteristics of the two groups (age, sex, history of injury, past medical histories, CT or MRI diagnostic indicators) also showed no statistical difference (all P > 0.05). CONCLUSIONS YL-1 puncture needle surgery with irrigation and closed-system drainage is an effective surgical treatment for CSDH. Atorvastatin has no statistically significant effect on the prevention of CSDH recurrence after surgery.
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Affiliation(s)
- Dongdong Wang
- School of Clinical Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116000, China; Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Hui Wang
- School of Clinical Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116000, China; Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Min Xu
- Department of Neurosurgery, Traditional Chinese Medicine Hospital of Kunshan, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, 189 Chaoyang Road, Kunshan, Jiangsu Province, 215300, China
| | - Pin Chen
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Bo Yu
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Jinkun Wen
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Hengzhu Zhang
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Wei Zeng
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Shiwei He
- School of Clinical Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116000, China; Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China
| | - Cunzu Wang
- Department of Neurosurgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, Jiangsu Province, 225001, China.
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Zhang P, Li Y, Huang J, Zhang H, Wang X, Dong L, Yan Z, She L. Chronic subdural haematoma in antithrombotic cohorts: characteristics, surgical outcomes, and recurrence. Br J Neurosurg 2020; 34:408-415. [DOI: 10.1080/02688697.2020.1749987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Peng Zhang
- Department of Neurosurgery, DaLian Medical University, DaLian, China
| | - Yuping Li
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Jiannan Huang
- Department of Neurosurgery, DaLian Medical University, DaLian, China
| | - Hengzhu Zhang
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Xiaodong Wang
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Lun Dong
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Zhengcun Yan
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Lei She
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China
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Audette MA, Bordas SPA, Blatt JE. Robotically Steered Needles: A Survey of Neurosurgical Applications and Technical Innovations. ROBOTIC SURGERY : RESEARCH AND REVIEWS 2020; 7:1-23. [PMID: 32258180 PMCID: PMC7090177 DOI: 10.2147/rsrr.s224446] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue shift estimation through imaging scans acquired during the procedure, and simulation-based prediction. Neurosurgical scenarios tend to emphasize straight needles so far, and span deep-brain stimulation (DBS), stereoelectroencephalography (SEEG), intracerebral drug delivery (IDD), stereotactic brain biopsy (SBB), stereotactic needle aspiration for hematoma, cysts and abscesses, and brachytherapy as well as thermal ablation of brain tumors and seizure-generating regions. We emphasize therapeutic considerations and complications that have been documented in conjunction with these applications.
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Affiliation(s)
- Michel A Audette
- Department of Computational Modeling and Simulation Engineering, Old Dominion University, Norfolk, VA, USA
| | - Stéphane P A Bordas
- Institute of Computational Engineering, University of Luxembourg, Faculty of Sciences Communication and Technology, Esch-Sur-Alzette, Luxembourg
| | - Jason E Blatt
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
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Xu M, Wang WH, Zhu SQ, Tan WG, Jin XG, Lu W, Chen L. Effects of minimally invasive approaches on chronic subdural hematoma by novel YL-1 puncture needle and burr-hole methods. Acta Neurol Belg 2020; 120:37-42. [PMID: 29623601 DOI: 10.1007/s13760-018-0914-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 11/28/2022]
Abstract
The objective of this study is to investigate effects of minimally invasive approaches on outcome of chronic subdural hematoma (CSDH) by novel YL-1 puncture needle and burr-hole methods. A retrospective analysis was performed in 158 hospitalized CSDH patients from January, 2013 to December, 2017 in Kunshan Hospital of Traditional Chinese Medicine. Patients' gender, age, history of trauma, volume of hematoma, hematoma location, application of urokinase, surgical approach, the operation time, hospitalized time, and CT scans 3 months after discharge were recorded. Prognostic indicators including symptom relief and post-hospital neuro-imaging findings were extracted to evaluate surgical efficacy. Statistical methods were conducted to evaluate surgical efficacy. Both YL-1 puncture needle and burr-hole surgeries had a satisfying follow-up (93.67%). There was non-significant group difference in follow-up results (p > 0.05). While YL-1 needle group needs less operation time ((p < 0.001) and hospitalized time (p < 0.001), gender (p = 0.144), age (p = 0.394), history of head trauma (p = 0.445), volume of hematoma (p = 0.068), hematoma location (p = 0.281), and application of urokinase (p = 0.545) were shown non-significantly associated with these two minimally invasive approaches. Volume of hematoma was significantly associated with follow-up outcomes (p = 0.016). Novel YL-1 puncture needle and classic burr-hole craniotomy are both proved to be safe and effective minimally invasive surgeries, which can provide an early intervention and minimally invasive strategy for neurosurgeons.
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Affiliation(s)
- Min Xu
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Wen-Hua Wang
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Sheng-Qiang Zhu
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Wei-Guo Tan
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Xue-Gang Jin
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Wei Lu
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Long Chen
- Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, 215300, Jiangsu, China.
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Wang J, Wu QY, Du CP, Liu J, Zhang H, Wang JY, Xue W, Chen SL. Spontaneous cerebellar hemorrhage with severe brainstem dysfunction through minimally invasive puncture treatment by locating the simple bedside. Medicine (Baltimore) 2019; 98:e17211. [PMID: 31567974 PMCID: PMC6756735 DOI: 10.1097/md.0000000000017211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to evaluate the feasibility and effectiveness of minimally invasive puncture treatment by positioning the simple bedside for spontaneous cerebellar hemorrhage.From January 2017 to March 2018, the investigators applied simple bedside positioning to perform the intracranial hematoma minimally invasive surgery for 21 patients with cerebellar hemorrhage.For these 21 patients, the bleeding amount and Glasgow Coma Scale (GCS) score before the operation were 18.5 ± 5.0 cc and 9.5 ± 3.3, respectively; 24 hours after the operation, the GCS score was 11.0 ± 4.6. Five patients died within 7 days of the operation and the head computed tomography (CT) was re-examined. It was found that the average bleeding amount was 3.4 ± 0.9 cc, the operation success rate was 76.2%, and the accurate puncture rate was 100%. Six months later, the Modified Rankin Scale (MRS) score was 2.5 ± 2.0. The postoperative recovery was good. The situation shows that patients with favorable outcomes (MRS score 0-2) accounted for 38.1% (8/21), and the fatality rate was 33.3% (7/21).The efficacy of the intracranial hematoma minimally invasive surgery by positioning the simple bedside for spontaneous cerebellar hemorrhage with severe brainstem dysfunction is good.
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Affiliation(s)
| | | | | | | | - Hua Zhang
- Department of Radiology, Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Jun-Yan Wang
- Department of Radiology, Chongqing Three Gorges Central Hospital, Chongqing, China
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Abstract
Objective: The proportion of the super-aged population (at the age of 80 or above) in patients with chronic subdural hematoma (CSDH) and the incidence of CSDH of the population have been increasing. Since it is widely accepted that YL-1 needle is effective in CSDH treatment, this paper aimed to probe into the efficacy of YL-1 needle in minimally invasive surgery for super-aged (at the age of 80–90) CSDH patients. Methods: A retrospective analysis on the clinical information of 17 super-aged CSDH patients having received the YL-1 needle puncture treatment provided by the hospital from May 2012 to December 2016 was performed. At the same time, another 19 CSDH patients (ages 60–79) who were hospitalized during the same period were randomly selected to form a control group. The same surgical treatment was provided for both groups to observe and compare the treatment efficacy. Results: The patients of both groups were cured and discharged. Among the super-aged patients, there was 1 patient with postoperative hematoma recurrence, 1 patient with pneumocephalus, and 1 patient with wound infection; among the aged patients, 1 reported postoperative recurrence and 2 had pneumocephalus; The average length of stay of the super-aged group was 9.235 ± 2.948 days while that of the aged group was 7.316 ± 3.660 days, which showed no statistical difference. Conclusion: The YL-1 needle puncture treatment is safe and efficacious for both the super-aged and the aged CSDH patients.
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