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Seong Keun Moon 1 Article
Comparison of the Surgical Approaches for Frontal Traumatic Intracerebral Hemorrhage
Eun Sung Park, Seong Keun Moon, Ki Seong Eom
J Trauma Inj. 2019;32(2):71-79.   Published online June 30, 2019
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AbstractAbstract PDF

Recent developments in minimally invasive techniques have the potential to reduce surgical morbidity, promote patient recovery, accelerate surgical procedures, and thus improve cost-effectiveness in case management. In this study, we compared the treatment efficacy and results of supraorbital keyhole approach (SOKA) with those of conventional unilateral frontal craniotomy (CUFC) for traumatic intracerebral hemorrhage (TICH) in the frontal lobe.


We analyzed the data of 38 patients who underwent CUFC (n=30) and SOKA (n=8) and retrospectively reviewed their medical records and radiological findings. Furthermore, we tried to identify the best surgical method for such lesions by including patients who underwent burr hole aspiration and drainage (BHAD) (n=9) under local anesthesia due to various circumstances.


The difference in the initial Glasgow coma scale score, operative time, and length of hospitalization between the CUFC and SOKA were statistically significant. All radiological features between the two groups including associated skull fracture, amount of pre- and postoperative hematoma, percentage of complete hematoma removal, pre- and postoperative midline shifting of the hematoma, and development of postoperative delayed hematoma were not statistically significant. Our experience of 46 patients with TICH in the frontal lobe with any of the three different surgical methods including BHAD enabled us to obtain valuable findings.


Although it is difficult to insist that one particular approach is more useful than the other, we are confident that SOKA will have more advantages over CUFC in carefully selected patients with frontal TICH depending on the surgical experience of a neurosurgeon.



Citations to this article as recorded by  
  • Applications of supraorbital keyhole craniotomy in pediatric cranial trauma: illustrative series of two cases and systematic literature review
    Joshua J. Loya, Chenyi Yang, Zach Pennington, Nolan J. Brown, Ali I. Rae, Jesse L. Winer
    Child's Nervous System.2023; 39(12): 3531.     CrossRef
  • A Study to Evaluate Prognostic Factors and Define a Critical Volume for Early Surgery in Patients with Bifrontal Brain Contusions
    Manoranjitha Kumari M, T.P. Jeyaselva Senthilkumar, Yamunadevi Ravi
    Indian Journal of Neurosurgery.2023;[Epub]     CrossRef
  • Supraorbital eyebrow approach: A single-center experience
    Blessing Ndlovu, Mohammed Ouwais Abdul Sattar, Mlamuli Mzamo Mkhaliphi, Keletso Leola, Morena Nthuse Mpanza, John Richard Ouma, Christos Profyris
    Surgical Neurology International.2022; 13: 566.     CrossRef
  • Re: Comparison of the Surgical Approaches for frontal Traumatic Intracerebral Hemorrhage
    Luis Rafael Moscote-Salazar, Ezequiel Garcia-Ballestas, Pradeep Chouksey, Amit Agrawal
    Journal of Trauma and Injury.2020; 33(1): 59.     CrossRef

J Trauma Inj : Journal of Trauma and Injury