Neuroendoscopic Aspiration of Hematocephalus Totalis: Technical Note

Abstract

Intraventricular hemorrhage, analogously to other ventricular diseases, can be treated successfully with flexible endoscopes. Obviously, the limitation of this study lies in its observational nature; however, the encouraging results reported here should prompt a randomized study to evaluate the effectiveness and efficiency of the endoscopic approach in comparison to the more established semiconservative management offered by external derivation with fibrinolytic agents.

Comparison of Clinical Outcomes of Intraventricular Hematoma Between Neuroendoscopic Removal and Extraventricular Drainage

“…3,8,9,14) Good results have been reported with the use of only a flexible endoscope, but we have been performing IVH removal with both a rigid endoscope and a flexible endoscope. Rigid endoscopes afford higher image resolution than flexible endoscopes, and the use of a transparent sheath and aspiration tubes permits rapid hematoma removal.…”

“…Communicating hydrocephalus after IVH may be caused by dysfunction of the cerebrospinal fluidreabsorbing Pacchioni granulations of the arachnoidea, so endoscopic removal of IVH in the acute phase may reduce the incidence of communicating hydrocephalus in the chronic phase. 12) A shunt procedure is required in 0% to 17% of cases after neuroendoscopy, 3,8,9,14) compared to 13.9% to 33% of cases after EVD. 6,7,10) However, whether neuroendoscopic surgery significantly reduces the incidence of communicating hydrocephalus remains unclear.…”

“…1) Recent progress in neuroendoscopy allows minimally invasive surgery for patients with cerebral hemorrhage, and use of this technique for IVH can safely achieve reliable decompression and improvement of non-communicating hydrocephalus in the acute phase. 4,8,9,14) The present study describes our surgical technique of endoscopic evacuation for IVH, using both rigid and flexible endoscopes for aggressive treatment of hyperacute IVHs, compares the outcomes achieved by endoscopic removal and by EVD at our hospital, and discusses the usefulness of endoscopic removal.…”

Neuroendoscopic Findings of Ventricular Wall in Adult Hemorrhagic Moyamoya Disease: Report of Two Cases

“…2,3) The introduction of neuroendoscopic surgery has improved the safety and prognosis of the removal of intraventricular hemorrhage. [4][5][6][7][8][9][10] Neuroendoscopic surgery has often been performed to treat hypertensive intracerebral hemorrhage. Recently, the indication for neuroendoscopic surgery has been extended to cast-formation intraventricular hematoma.…”

A Pitfall of Neuroendoscopic Intraventricular Hematoma Removal - Delayed Obstructive Hydrocephalus Caused by a Small Remnant Clot -Case Report-

“…3,[7][8][9]12) IVH is considered to indicate a poor prognosis and is characterized by a relatively high mortality rate. 4) Massive IVH disrupts the cerebrospinal fluid (CSF) circulation, resulting in acute hydrocephalus, and negatively affects mortality in the acute phase.…”