Journal of Cerebrovascular and Endovascular Neurosurgery

  • 제25권4호
  • /
  • Pages.403-410
  • /
  • 2023
  • /
  • 2234-8565(pISSN)
  • /
  • 2287-3139(eISSN)
대한뇌혈관외과학회 (Korean Society of Cerebravascular Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Safe and time-saving treatment method for acute cerebellar infarction: Navigation-guided burr-hole aspiration - 6-years single center experience

  • Min-Woo Kim (Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Eun-Sung Park (Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Dae-Won Kim (Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Sung-Don Kang (Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine)
  • 투고 : 2023.08.08
  • 심사 : 2023.09.05
  • 발행 : 2023.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: While patients with medically intractable acute cerebellar infarction typically undergo suboccipital craniectomy and removal of the infarcted tissue, this procedure is associated with long operating times and postoperative complications. This study aimed to investigate the effectiveness of minimally invasive navigation-guided burr hole aspiration surgery for the treatment of acute cerebellar infarction. Methods: Between January 2015 and December 2021, 14 patients with acute cerebellar infarction, who underwent navigation-guided burr hole aspiration surgery, were enrolled in this study. Results: The preoperative mean Glasgow Coma Scale (GCS) score was 12.7, and the postoperative mean GCS score was 14.3. The mean infarction volume was 34.3 cc at admission and 23.5 cc immediately following surgery. Seven days after surgery, the mean infarction volume was 15.6 cc. There were no surgery-related complications during the 6-month follow-up period and no evidence of clinical deterioration. The mean operation time from skin incision to catheter insertion was 28 min, with approximately an additional 13 min for extra-ventricular drainage. The mean Glasgow Outcome Scale score after 6 months was 4.8. Conclusions: Navigation-guided burr hole aspiration surgery is less time-consuming and invasive than conventional craniectomy, and is a safe and effective treatment option for acute cerebellar infarction in selected cases, with no surgery-related complication.

키워드

과제정보

This paper was supported by wonkwang university in 2022.

참고문헌

  1. Amar AP. Controversies in the neurosurgical management of cerebellar hemorrhage and infarction. Neurosurg Focus. 2012 Apr;32(4):e1.
  2. Datar S, Rabinstein AA. Cerebellar infarction. Neurol Clin. 2014 Nov;32(4):979-91. https://doi.org/10.1016/j.ncl.2014.07.007
  3. Hadanny A, Rozovski U, Nossek E, Shapira Y, Strauss I, Kanner AA, et al. Craniectomy versus craniotomy for posterior fossa metastases: Complication profile. World Neurosurg. 2016 May;89:193-8. https://doi.org/10.1016/j.wneu.2016.01.076
  4. Juttler E, Schweickert S, Ringleb PA, Huttner HB, Kohrmann M, Aschoff A. Long-term outcome after surgical treatment for space-occupying cerebellar infarction: Experience in 56 patients. Stroke. 2009 Sep;40(9):3060-6. https://doi.org/10.1161/STROKEAHA.109.550913
  5. Khoshnevisan A, Allahabadi NS. Neuronavigation: Principles, clinical applications and potential pitfalls. Iran J Psychiatry. 2012 Spring;7(2):97-103.
  6. Kim MJ, Park SK, Song J, Oh SY, Lim YC, Sim SY, et al. Preventive suboccipital decompressive craniectomy for cerebellar infarction: A retrospective-matched case-control study. Stroke. 2016 Oct;47(10):2565-73. https://doi.org/10.1161/STROKEAHA.116.014078
  7. Koh MG, Phan TG, Atkinson JL, Wijdicks EF. Neuroimaging in deteriorating patients with cerebellar infarcts and mass effect. Stroke. 2000 Sep;31(9):2062-7. https://doi.org/10.1161/01.STR.31.9.2062
  8. Kwon WK, Park DH, Park KJ, Kang SH, Lee JH, Cho TH, et al. Prognostic factors of clinical outcome after neuronavigation-assisted hematoma drainage in patients with spontaneous intracerebral hemorrhage. Clin Neurol Neurosurg. 2014 Aug;123:83-9. https://doi.org/10.1016/j.clineuro.2014.05.016
  9. Lee JH, Kim DW, Kang SD. Stereotactic burr hole aspiration surgery for spontaneous hypertensive cerebellar hemorrhage. J Cerebrovasc Endovasc Neurosurg. 2012 Sep;14(3):170-4. https://doi.org/10.7461/jcen.2012.14.3.170
  10. Macdonell RA, Kalnins RM, Donnan GA. Cerebellar infarction: Natural history, prognosis, and pathology. Stroke. 1987 Sep;18(5):849-55. https://doi.org/10.1161/01.STR.18.5.849
  11. MacLullich AM, Edmond CL, Ferguson KJ, Wardlaw JM, Starr JM, Seckl JR, et al. Size of the neocerebellar vermis is associated with cognition in healthy elderly men. Brain Cogn. 2004 Dec;56(3):344-8. https://doi.org/10.1016/j.bandc.2004.08.001
  12. Neugebauer H, Witsch J, Zweckberger K, Juttler E. Space-occupying cerebellar infarction: complications, treatment, and outcome. Neurosurg Focus. 2013 May;34(5):e8.
  13. Raco A, Caroli E, Isidori A, Vangelista T, Salvati M. Management of acute cerebellar infarction: One institution's experience. Neurosurgery. 2003 Nov;53(5):1061-5; discussion 1065-6. https://doi.org/10.1227/01.NEU.0000088766.34559.3E
  14. Raz N, Rodrigue KM, Kennedy KM, Dahle C, Head D, Acker JD. Differential age-related changes in the regional metencephalic volumes in humans: A 5-year follow-up. Neurosci Lett. 2003 Oct;349(3):163-6. https://doi.org/10.1016/S0304-3940(03)00820-6
  15. Zhang SQ, Wang W, Ma XL, Xia YY, Liu AJ. Anticoagulation therapy is harmful to large-sized cerebellar infarction. CNS Neurosci Ther. 2014 Sep;20(9):867-73. https://doi.org/10.1111/cns.12299