From the Research
The SESAME procedure can have several complications, but the most recent and highest quality evidence does not specifically address these complications, therefore, careful patient selection, meticulous surgical technique, proper postoperative care, and appropriate antibiotic prophylaxis are essential to minimize risks. The SESAME procedure, a minimally invasive technique, can have several complications, including recurrence of the hematoma, infection at the surgical site, seizures, and pneumocephalus. Less frequent but serious complications include intracerebral hemorrhage, tension pneumocephalus, and brain injury. Patients may also experience headache, dizziness, and temporary neurological deficits following the procedure. Risk factors that increase complication rates include advanced age, use of anticoagulants, multiple medical comorbidities, and larger hematoma size. To minimize these risks, careful patient selection, meticulous surgical technique, proper postoperative care including head positioning, and appropriate antibiotic prophylaxis are essential. Most complications are manageable with prompt recognition and intervention, and the overall safety profile of SESAME is favorable compared to traditional craniotomy approaches, which is why it has become increasingly popular for treating chronic subdural hematomas in suitable candidates, although the provided evidence 1, 2, 3, 4, 5 does not directly address the complications of the SESAME procedure. Some of the provided evidence discusses the use of antiplatelet agents in vascular neurosurgery 1, percutaneous coronary intervention for ST-elevation myocardial infarction 2, antiplatelet therapy in acute coronary syndromes 3, dual antiplatelet therapy and non-cardiac surgery 4, and managing adverse effects and drug-drug interactions of antiplatelet agents 5, but these are not directly related to the SESAME procedure complications. Therefore, the decision to perform the SESAME procedure should be made on a case-by-case basis, taking into account the individual patient's risk factors and medical history. It is also important to note that the provided evidence is not directly related to the SESAME procedure, and more research is needed to fully understand the complications and risks associated with this procedure. However, based on the available evidence, careful patient selection, meticulous surgical technique, proper postoperative care, and appropriate antibiotic prophylaxis are essential to minimize the risks associated with the SESAME procedure. Some key points to consider when evaluating the risks and benefits of the SESAME procedure include:
- Careful patient selection to minimize the risk of complications
- Meticulous surgical technique to reduce the risk of infection and other complications
- Proper postoperative care, including head positioning and appropriate antibiotic prophylaxis, to minimize the risk of complications
- Individualized decision-making to take into account the patient's unique risk factors and medical history. Overall, while the SESAME procedure can have several complications, careful patient selection, meticulous surgical technique, proper postoperative care, and appropriate antibiotic prophylaxis can help minimize these risks and improve outcomes for patients undergoing this procedure.