Minim Invasive Neurosurg 2003; 46(5): 278-283
DOI: 10.1055/s-2003-44451
Original Article
© Georg Thieme Verlag Stuttgart · New York

Neuroendoscopic Surgery for Intracerebral Haemorrhage - Comparison with Traditional Therapies

T.  Nakano1 , H.  Ohkuma1 , K.  Ebina2 , S.  Suzuki1
  • 1Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan
  • 2Ebina Neurosurgical Clinic, Hirosaki, Japan
Further Information

Publication History

Publication Date:
19 November 2003 (online)

Abstract

Endoscopy is a new therapeutic option for hypertensive intracerebral haemorrhage. Although it has the advantages of being less invasive than craniotomy and more effective than conservative treatment, not all patients are candidates for it. Since it is important to clarify which characteristics of patients are indications for this operation, we retrospectively evaluated the role of endoscopic surgery in comparison with traditional treatments for hypertensive intracerebral haemorrhage. Seven patients were treated with endoscopic surgery in our institution between January 2000 and November 2001. Two had thalamic haemorrhage, 4 putaminal haemorrhage, and 1 intracerebral haemorrhage. The average age of patients was 55 years. Endoscopic operation was mainly selected for haematomas more than 20 ml and less than 40 ml in volume. Generally, endoscopy yielded good outcomes with GR in 50 % of patients. Adequate indications for endoscopic operation may be the following;
1) Putaminal haematoma of small-intermediate size,
2) Haematoma situated deep in the brain, e. g., thalamic haemor-rhage,
3) Intraventricular haematoma,
4) High-risk patients who cannot tolerate general anaesthesia.

References

  • 1 Ebina K, Andoh A, Takahashi T, Iwabuchi T. Development and clinical usefulness of a new neuroendoscope system for CT-guided stereotactic brain surgery.  Neurol Med Chir (Tokyo). 1990;  30 401-407
  • 2 Ebina K, Kim B, Suzuki S, Iwabuchi T. Development and clinical usefulness of stereotactic endoneurosurgical system for intracerebral hematoma.  No Socchu no Geka (Surg Cereb Stroke). 1995;  23 109-115
  • 3 Auer L M, Deinsberger W, Niederkorn K, Gell G, Kleinert R, Schneider G, Holzer P, Bone G, Mokry M, Korner E, Kleinert G, Hanusch S. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study.  J Neurosurg. 1989;  70 530-535
  • 4 Nishihara T, Teraoka A, Morita A, Ueki K, Takai K, Kirino T. A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas.  J Neurosurg. 2000;  92 1053-1055
  • 5 Kandel E I, Peresedov V V. Stereotaxic evacuation of spontaneous intracerebral hematomas.  J Neurosurg. 1985;  62 206-213
  • 6 Komai N. CT-guided stereotactic operation.  Nippon Rinsho. 1984;  42 959-974

Takahiro Nakano,M. D. 

Department of Neurosurgery · Hirosaki University School of Medicine

Zaifucho 5 · Hirosaki, 036-8562 · Japan

Phone: +81-172-39-5115

Fax: +81-172-39-5116

Email: naka@cc.hirosaki-u.ac.jp