Analysis of neurosurgical-preoperative planning methods for chronic subdural hematoma evacuation

This study presents a specialized C++/VTK-based software application designed to automate and optimize preoperative planning for chronic subdural hematoma (CSDH) evacuation. Utilizing the Imaginary Center of the Cranial Cavity (ICCC) algorithm and ray-casting techniques, the system objectively calculates optimal surgical entry points, trepanation diameters, and endoscope insertion depths from patient-specific 3D geometric models. Background and Objective: Chronic subdural hematoma (CSDH) is a highly prevalent neurosurgical condition, particularly among aging populations. While the integration of rigid neuroendoscopy significantly improves clinical outcomes and reduces recurrence rates, preoperative planning—including entry point selection, burr hole diameter determination, and safe insertion depth estimation—remains largely empirical and dependent on subjective 2D computed tomography (CT) reviews. This study aims to design, implement, and validate automated computational algorithms to optimize patient-specific neurosurgical intervention parameters for CSDH evacuation using 3D geometric models.