Three-dimensional computed tomography-guided multitract aspiration of extensive ganglionic hemorrhage: technical note

Area of Science:

• Neurosurgery
• Medical Imaging
• Minimally Invasive Procedures

Background:

• Intracerebral hematomas pose significant challenges in neurosurgery.
• Effective lysis and drainage are crucial for patient recovery.
• Stereotactic surgery offers a minimally invasive approach.

Purpose of the Study:

• To present a novel methodology for improving intracerebral hematoma lysis and drainage.
• To evaluate the efficacy of a 3D-CT-guided multitrack stereotactic technique.
• To assess neurological outcomes following the procedure.

Main Methods:

• Stereotactic aspiration using a multitrack technique in 20 patients with ganglionic hemorrhages.
• 3-dimensional computed tomography (3D-CT) guidance for precise trajectory and target selection.
• Insertion of 4-5 drains for parenchymal and ventricular clots, with repeated urokinase injections.

Main Results:

• Precise catheter placement achieved using 3D-CT visualization.
• Complete removal of deep and subcortical hematomas within a mean of 10 hours.
• Favorable neurological outcome in 16 out of 20 patients (80%) with no complications from catheter placement.

Conclusions:

• The 3D-CT-based multitrack technique is rapid and effective for extensive ganglionic hemorrhage removal.
• This method offers potential for better neurological recovery compared to conventional techniques.
• The technique is advantageous for selected patients requiring extensive hematoma evacuation.