Management of Chronic Subdural Hematomas with Subdural Evacuation Port System: A Single Center Retrospective Review

Authors

  • Fraser Henderson Tenwek Mission Hospital Kenya and Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Ryan Kellogg Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Stephen Lowe Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Jeffrey Wessell Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Zachary Henderson Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Orgest Lajthia Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Laura Wolgamott Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Guillerme Porto Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Thomas Larrew Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Jaime Martinez Santos Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Mohammed Alshareef Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  • Ahmed Alshareef Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA

Keywords:

chronic subdural hematoma, burr hole, subdural hematoma, Brain tumors

Abstract

Objective: Chronic subdural hematoma (cSDH) is prevalent globally and its management is evolving to minimize morbidity while optimizing theater utilization. We present our institution’s experience with subdural evacuation port system (SEPS) as a first-line treatment approach to cSDHs. Methods: A retrospective review was performed of patients undergoing bedside SEPS placement in a single institution. Pre- and post-procedural radiographic and clinical data were collected and analyzed to identify predictive variables of procedural success for the SEPS approach. For procedure failures, subsequent procedures were analyzed for rates of success. Results: 268 patients were identified for a total of 326 initial procedures. Pre-procedural variables associated with improved odds of a good outcome were: unilateral cSDH, prior use of anticoagulation, GCS > 13 at presentation, larger cSDH, and greater degree of midline shift (MLS). 65% success rate was observed for initial SEPS placement and an overall success of 78% after repeat SEPS. Patients with subsequent failures underwent craniotomy. Conclusions: Bedside SEPS placement is a low-risk option for first-line treatment of cSDH and may spare patients from the risks of general anesthesia while reducing burden on surgical theaters in resource-limited settings. Performing a repeat SEPS procedure is a reasonable surgical option if the first procedure fails to completely evacuate the cSDH.

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Published

30-01-2024

How to Cite

1.
Henderson F, Kellogg R, Lowe S, Wessell J, Henderson Z, Lajthia O, et al. Management of Chronic Subdural Hematomas with Subdural Evacuation Port System: A Single Center Retrospective Review. EAJNS [Internet]. 2024 Jan. 30 [cited 2024 Dec. 22];3(1):1-8. Available from: https://theeajns.org/index.php/eajns/article/view/225

Issue

Vol. 3 No. 1 (2024): Vol 3, issue 1

Section

Original articles

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