No abstract

Primary intraventricular hematomas account for approximately 6% of all intracerebral hematomas. If the clot blocks cerebrospinal fluid (CSF) pathways, surgical intervention, which may be of different types, can be life-saving. In the case reported here, after careful preoperative planning the use of two rigid endoscopes permitted the removal of most of the intraventricular clot and restoration of CSF circulation by creation of a 3rd ventriculostomy within the same procedure and no later treatment was necessary. Repeated CT scans proved that only a small portion of the intraventricular clot remained in the ventricular system. The ventricular size normalised, and the patency of the artificial hole in the floor of the 3rd ventricle was demonstrated both by the rapidly improving clinical picture of the patient and by flow-sensitive MRI studies. For individuals who suffer primary intraventricular hemorrhage and later develop occlusive hydrocephalus, endoscopic removal of the clot and 3rd ventriculostomy might offer a more adequate treatment option than external ventricular drainage.

No abstract

The biportal endoscopic approach allowed independent visual control of both procedures, safe passages of the ventriculoscopes via the narrow foramen of Monro, and facile control of the intracranial pressure in the ventricles via the available four irrigation channels during the performance of tumor biopsy and fenestration of the floor of the third ventricle. In selected patients with infiltrating posterior third ventricle tumors, this procedure and postoperative radiotherapy may be an alternative to direct surgery or to shunting and performance of image-guided biopsy.