Nakano T, Ohkuma H, Ebina K, Suzuki S
Department of Neurosurgery, Hirosaki University School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
Minim Invasive Neurosurg. 2003 Oct;46(5):278-83. doi: 10.1055/s-2003-44451.
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 haemorrhage, 3) Intraventricular haematoma, 4) High-risk patients who cannot tolerate general anaesthesia.
