Endoscopic surgery for thalamic hemorrhage: a technical note (original) (raw)
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World neurosurgery, 2011
Intraventricular hemorrhage (IVH) caused by thalamic hemorrhage has high mortality and morbidity. The aim of this study was to investigate the efficacy and the results of endoscopic surgery for the evacuation of IVH caused by thalamic hemorrhage compared with that of external ventricular drainage (EVD) surgery. From January 2006 to December 2008, 48 patients with IVH caused by thalamic hemorrhage were enrolled and treated in our department. Patients with IVH caused by thalamic hemorrhage who also resulted in acute hydrocephalus were indicated for surgery; the patients who were included were randomly divided into an EVD group and an endoscopic surgery group. The clinical evaluation data included the Glasgow Coma Scale, length of intensive care unit (ICU) stay, age, intracerebral hemorrhage volume, and severity of IVH. Outcome was measured using the 30-day and 90-day mortality rate, ventriculoperitoneal (VP) shunt dependent rate, and Glasgow Outcome Scale after three months. The clini...
Surgical treatment of thalamic hematomas via the contralateral transcallosal approach
Neurosurgical Review, 2001
Acute management of deep-seated hematomas remains controversial. Since patients with these hematoma later tend to develop severe edema and necrosis around the lesion, when surgery is indicated it should be done as early as possible. The purpose of this study was to compare whether early surgical removal and conservative treatment of primary thalamic hematoma correlated with improved neurological outcome. Last year, 61 patients with primary thalamic hematomas were admitted to our institution. Of these, 21 underwent surgery via contralateral transcallosal approach during the ultraearly stage (within 6 hours) after the apoplectic attack, and 24 patients were treated conservatively.
Endoscopic-assisted removal of traumatic brain hemorrhage: case report and technical note
Journal of surgical case reports, 2015
The endoscopic technique has been described as a minimally invasive method for spontaneous hematoma evacuation, as a safe and effective treatment. Nevertheless, to our knowledge, there is no description of a technical report of traumatic intracerebral hematoma removal using the neuroendoscope. A 47-year-old man was admitted sustaining 13 points in Glasgow coma scale with brain computed tomography (CT) scan showing a temporal contusion. Guided by a 3D reconstructed CT, using the program OsiriX®, the posterior limit of the hematoma was identified. A burr hole was placed at the posterior temporal region, and we used the neuroendoscope to assist the hematoma evacuation. The postoperative tomography showed adequate hematoma removal. He was discharged from hospital 48 h after surgery. Two weeks later, he was conscious and oriented temporally. This endoscopic-assisted technique can provide safe removal of traumatic hematomas of the temporal lobe.
2015
Objectives: Endoscopic evacuation of intracerebral hemorrhage (ICH) has been developed in order to reduce the tissue injury that conventional craniotomy could generate. Experimental studies are important to assess the effectiveness of the technique and its modifications. The objectives of this study are to develop in pig an experimental model of endoscopic evacuation of ICHs, to assess effectiveness of surgical evacuation, and to evaluate a new transparent sheath as complement to the endoscopy. Methods: Autologous blood was infused into the frontal lobe white matter in 16 pigs. In the problem group, endoscopic evacuation was performed with the aid of a new transparent sheath, which has outer and inner sheaths with blunt and closed finals. Pigs were sacrificed at 4 h, 24 h and 5 days. The volumes of hematoma and histopathological features were determined. Results: Residual volume of the problem group was significantly 70.09% lower than in control group, without significant difference...
Endoscopic management of spontaneous intracerebral haemorrhage
2020
Background: Endoscopic evacuation of spontaneous intracerebral haemorrhage has gained accepted popularity in the last decades as a minimally invasive technique alternative to traditional craniotomy with increased range of surgical indications to include the ganglionic haematomas that were previously inaccessible. Objectives: to enlighten the endoscopic use for evacuation of intracerebral hemorrhage. Patients & Methods: This study describes a prospective study that was conducted in faculty of medicine Al Azhar University and Damanhour medical national institute from November 2017 to November 2019 to evaluate the use of surgical endoscope in evacuation of spontaneous intracerebral haemorrhage. Results: the study included 28 patients, the intraoperative time was 75 ± 18.65 minutes, the evacuation rate was 90.98% ± 4.6%, and the post-operative Glascow coma scale improved to a mean of 8.50 ± 3.46. Conclusion: The endoscopic evacuation of spontaneous intracerebral hemorrhage is less invas...
Cureus 13(8): e17302, 2021
Nowadays, endoscopic third ventriculostomy (ETV) in neurosurgery has yielded good clinical results in various conditions. Intraventricular endoscopic procedures can be performed in different pathologies and not only in non-communicating hydrocephalus. This is presented accordingly in this clinical case. We present the case of a patient who suffered a blunt traumatic brain injury (TBI) in the occipital region. Upon his arrival at the medical facility, he displayed altered neurological status and showed symptoms of aggressiveness, slurred speech, and gait ataxia. Initial non-contrast brain computed tomography scan presented a cerebellar traumatic subacute hematoma and secondary hydrocephalus. Therefore, we performed an ETV. In most reported cases of cerebellar contusions among patients with TBI, the treatment was suboccipital craniectomy, clot evacuation, and external ventricular drainage (EVD). Unlike this case, the determined procedure was minimally invasive through ETV for the resolution of hydrocephalus with good clinical outcomes in addition to low morbidity and mortality. This case shows in the setting of delayed intracerebellar traumatic hematoma with secondary hydrocephalus being the main cause of neurological deterioration, a minimally invasive treatment such as ETV is suitable.
Endoscopic treatment of intracerebral hemorrhage with massive ventricular hemorrhage
International Congress Series, 2004
Objective: We examined the benefits of endoscopic removal of an intraventricular hematoma, and third-ventriculostomy to treat patients with an intracerebral hemorrhage with massive ventricular hemorrhage. Methods: A total of 72 patients with idiopathic intracerebral hemorrhage were admitted to our institute from December 2000 to November 2002. Twenty-five of these patients presented with ventricular hemorrhage. Among them, nine patients suffered acute hydrocephalus and one patient suffered delayed hydrocephalus. The patients with acute hydrocephalus received surgical intervention to release the cerebrospinal fluid from the lateral ventricles. Ventricular drainages alone were placed in five cases, and endoscopic removal of an intraventricular hematoma and thirdventriculostomy was preferentially applied in four cases. Results: Among the five cases treated with ventricular drainages alone, three patients died and two patients survived (with drainages placed for 11 and 16 days). On the other hand, all of the four patients treated with endoscopy survived (with drainages placed for 0, 6, 9, and 21 days). Two of them were finally placed on a Ventriculo-Peritoneal shunt. Conclusions: Endoscopic surgery is a recommendable treatment for patients with intracerebral hemorrhage with massive ventricular hemorrhage because it is minimally invasive and can shorten the term of ventricular drainages.
Endoscopic Management of Intracerebral Hemorrhage
World Neurosurgery, 2013
Massive intraventricular hemorrhage is a life-threatening condition that requires aggressive management to decrease intracranial hypertension. Intraventricular blood is a strong prognostic predictor of outcome. We describe the technical details and clinical management of the neuroendoscopic aspiration of intraventricular blood in our 12 years' experience, highlighting pitfalls and advantages of the technique.
Journal of Neurosurgery
OBJECTIVE The object of this study was to present the surgical results of a large, single-surgeon consecutive series of patients who had undergone transcisternal (TCi) or transcallosal-transventricular (TCTV) endoscope-assisted microsurgery for thalamic lesions. METHODS This is a retrospective study of a consecutive series of patients harboring thalamic lesions and undergoing surgery at one institution between February 2007 and August 2019. All surgical and patient-related data were prospectively collected. Depending on the relationship between the lesion and the surgically accessible thalamic surfaces (lateral ventricle, velar, cisternal, and third ventricle), one of the following surgical TCi or TCTV approaches was chosen: anterior interhemispheric transcallosal (AIT), posterior interhemispheric transtentorial subsplenial (PITS), perimedian supracerebellar transtentorial (PeST), or perimedian contralateral supracerebellar suprapineal (PeCSS). Since January 2018, intraoperative MRI...