Surgical Techniques Development, Vol. 14, Pages 19: Endless-Loop Craniotomy for Revision Surgery After the Burr-Hole Evacuation of Chronic Subdural Hematoma—A Technical Note

Surgical Techniques Development doi: 10.3390/std14030019

Authors:
Artem Rafaelian
Sae-Yeon Won
Thomas M. Freiman
Florian Gessler
Daniel Dubinski

Background and Importance: Chronic subdural hematoma (cSDH) is a common and complex neurosurgical problem, particularly in elderly patients. Revision surgery for chronic subdural hematoma can be challenging, particularly in cases with inhomogeneous, firm consistency and extensive adhesions. Clinical Presentation: In this article, we present our endless-loop craniotomy technique, which offers a novel approach to address these challenges by performing the wide, curved exposure of the subdural space utilizing the already-present burr hole. This technique allows for a wide, unobstructed view of the subdural space, enabling the access and evacuation of this chronic and often adhesive subdural hematoma. Conclusion: We believe that endless-loop craniotomy is a valuable addition to the neurosurgeon’s armamentarium for managing complex cases of revision surgery in chronic subdural hematomas.

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Artem Rafaelian www.mdpi.com