Experience of endoscopic removal of hypertensive intracerebral hemorrhage

• Published in: Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko Vol. 79; no. 6; p. 71
• Main Authors: Gushcha, A O, Semenov, M S, Lepsveridze, L T
• Format: Journal Article
• Language: English
• Published: Russia (Federation) 2015
• Subjects: Aged; Female; Hemostasis, Endoscopic - adverse effects; Hemostasis, Endoscopic - methods; Humans; Intracranial Hemorrhage, Hypertensive - surgery; Male; Middle Aged; Neuroendoscopy - adverse effects; Neuroendoscopy - methods; Retrospective Studies
• ISSN: 0042-8817
• DOI: 10.17116/neiro201579671-76

This study was aimed at assessing the efficacy of endoscopic technique in surgery for hypertensive intracerebral hemorrhage. This paper focus on our experience (11 cases) of endoscopic removal of hypertensive intracerebral hemorrhage. The paper presents examples of endoscopic removal of hematomas located in the basal ganglia (9 cases) and in the posterior fossa (2 cases), causing occlusion at the fourth ventricle. In 3 patients (27%) with intraventricular hemorrhage, the removal of acute hematomas from the ventricular system with simultaneous endoscopic triple ventriculostomy was performed. Intervention was carried out within the first 6 hours in patients with hemispheric hematomas (in 90% of cases) and within 3-5 hours in patients with PCF hematomas. The article analyzes the functional outcomes in the early and late postoperative period. Complete regression of neurological symptoms was achieved in 4 (36%) patients and the remaining 7 (64%) patients had a moderate disability at discharge. In our opinion, endoscopic removal of hypertensive intracerebral hemorrhage is a promising method that meets all existing aspects of modern neurosurgery. The combination of rigid and flexible endoscopy provides new capabilities in surgery of patients with intraventricular hemorrhage.