Neuroendoscopic management of haematocephalus

The purpose of the paper was to publish the results of endoscopic treatment of primary and secondary haematocephalus in the group of 23 patients, treated by means of Wolf endoscopic system combined with frame based navigation with the aid of virtual reality environment. The procedure is aimed to remove blood clots from the cerebral ventricles and to reduce the volume of parenchymal haematoma in secondary haematocephalus during single surgical session. In the majority of the treated patients septostomy was added to make revision of both lateral ventricles possible from a single approach, and the operation was completed with endoscopic third ventriculostomy to reduce the amount of blood in the basal cisterns and to reestablish the patency of cerebrospinal fluid pathways, so that lumbar puncture can be safely done to facilitate the process of cleaning blood away from the cerebrospinal fluid. The surgery always facilitates the resorption of residual blood as well as blood degradation products, therefore late complications, such as posthaemorrhagic hydrocephalus, membranes and stenosis formation was prevented. Improvement of the clinical condition was obtained without the need for permanent drainage systems insertion. Lethal outcome in one patient and unfavourable clinical result in another three patients were unrelated to the endoscopic treatment. (Tab. 1, Fig. 2, Ref: 10.)