Tailor-Made Endoscopic Surgical Strategy for Severe Intraventricular Hemorrhage with Obstructive Hydrocephalus
| Autor: | Yota Suzuki, Toshihiro Ogiwara, Takatoshi Hasegawa, Takuya Nakamura, Yoshiki Hanaoka, Akifumi Yokota, Kiyoshi Ito, Tetsuyoshi Horiuchi, Fumiko Higashiyama, Fusakazu Oya, Yu Fujii |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Ventricular system Fourth ventricle 03 medical and health sciences 0302 clinical medicine Hematoma Modified Rankin Scale Humans Medicine Aged Cerebral Intraventricular Hemorrhage Retrospective Studies Aged 80 and over Intracerebral hemorrhage business.industry Mortality rate Endoscopic third ventriculostomy Middle Aged medicine.disease Surgery Treatment Outcome Intraventricular hemorrhage 030220 oncology & carcinogenesis Neuroendoscopy Female Neurology (clinical) business 030217 neurology & neurosurgery Hydrocephalus |
| Zdroj: | World Neurosurgery. 150:e771-e776 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2021.03.142 |
| Popis: | Background Severe intraventricular hemorrhage (IVH) is associated with a high mortality rate and poor functional outcome, even with recent neurosurgical developments. IVH requires emergent surgery to save the patient's life, but the optimal surgical strategy remains controversial. We assessed the results obtained with our tailor-made endoscopic surgical strategy for severe IVH with obstructive hydrocephalus. Methods Consecutive patients with severe IVH owing to intracerebral hemorrhage who were treated with endoscopic surgery in the acute phase were retrospectively reviewed. Both rigid and flexible endoscopes were used for removal of hematoma in the whole ventricular system. Endoscopic third ventriculostomy and septostomy were performed as appropriate in each individual case. Results Eight patients met the inclusion criteria and were included in the analysis. Sufficient IVH removal without neglecting the fourth ventricle was achieved with our technique in 6 of 8 cases (75.0%). Endoscopic third ventriculostomy and septostomy were added in 4 cases each (50.0%). Four patients (50.0%) had a marked recovery and a good outcome (modified Rankin Scale score ≤2) despite disease severity at onset. The procedure was completed successfully in all cases, and there were no surgery-related complications. Conclusions This study showed that our tailor-made endoscopic surgical strategy for severe IVH with obstructive hydrocephalus may be beneficial. |
| Databáze: | OpenAIRE |
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