Endoscopic brainwash after clipping a ruptured aneurysm of the communicating segment of the intracranial carotid artery.
| Autor: | da Costa MDS; Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Brazil., Lopes RRS; Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Brazil., Serrato-Avila JL; Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Brazil., Cavalheiro S; Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Brazil., Chaddad-Neto F; Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Brazil.; Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Surgical neurology international [Surg Neurol Int] 2020 Nov 18; Vol. 11, pp. 396. Date of Electronic Publication: 2020 Nov 18 (Print Publication: 2020). |
| DOI: | 10.25259/SNI_680_2020 |
| Abstrakt: | Background: Intracranial aneurysms are common vascular malformation occurring in 1-2% of the population and accounting for 80-85% of nontraumatic subarachnoid hemorrhages. About 10% of the ruptured aneurysm causing subarachnoid hemorrhage (SHA) develop intraventricular hemorrhage (IVH). In this scenario, the external ventricular drain (EVD) is a usual treatment for IVH. To reduce the time for the clot absorption, the neuroendoscopy with clot removal and ventricular irrigation is a feasible option, although not routinely used. Case Description: This 2D video shows a case of a 60-year-old female, with sudden headache associated with nausea and vomit. The brain angiotomography revealed aneurysm in the communicating segment of the left internal carotid artery, with 10.5 mm of diameter; also showed intraparenchymal, subarachnoid, and IVH, with a Fisher Modified Grade of 4 and a prompt aneurysm clipping and EVD were performed. Two days after the first surgical procedure, a neuroendoscopy was performed to remove the ventricular clots and improve the patient outcomes. Conclusion: In the presented case, at the 6 th postoperative month, the patient was Grade 1 in the Rankin Modified Scale and without hydrocephalus. This procedure can be used routinely as an additional tool to microsurgical clipping to improve patients outcome. Competing Interests: There are no conflicts of interest. (Copyright: © 2020 Surgical Neurology International.) |
| Databáze: | MEDLINE |
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