• Wei-Lung Tseng, Lu-Ting Kuo, Chien-Min Chen, Shih-Hung Yang, Chi-Tun Tang, Dar-Ming Lai, and Abel Po-Hao Huang.
• Fu Jen Catholic University Hospital, Department of Surgery, Division of Neurosurgery, New Taipei, Taiwan; National Taiwan University Hospital, Department of Surgery, Division of Neurosurgery, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
• J Formos Med Assoc. 2022 Jul 1; 121 (7): 1223-1230.

Background/PurposeAdequate decompression is the primary goal during surgical management of patients with traumatic brain injury (TBI). Therefore, it may seem counterintuitive to use minimally-invasive strategies to treat these patients. However, recent studies show that endoscopic-assisted minimally-invasive neurosurgery (MIN) can provide both adequate decompression (which is critical for preserving viable brain tissue) and maximize neurological recovery for patients with TBI. Hence, we reviewed the pertinent literature and shared our experiences on the use of MIN.MethodsThis was a retrospective multi-center study. We collected data of 22 TBI patients receiving endoscopic-assisted MIN within 72 hours after the onset, with Glasgow Coma Scale (GCS) scores of 6-14 and whose hemorrhage volume ranging from 30 to 70 mL.ResultsWe have applied MIN techniques to a group of 22 patients with traumatic ICH (TICH), epidural hematoma (EDH), and subdural hematoma (SDH). The mean pre-operative GCS score was 7.5 (median 7), and mean hemorrhage volume was 57.14 cm3 Surgery time was shortened with MIN approaches to a mean of 59.6 min. At 6-month follow-up, the mean GCS score had improved to 12.3 (median 15). By preserving more normal brain tissue, MIN for patients with TBI can result in beneficial effects on recoveries and neurological outcomes.ConclusionEndoscopic-assisted MIN in TBI is safe and effective in a carefully selected group of patients.Copyright © 2021. Published by Elsevier B.V.

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