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How I do it: flexible endoscopic aspiration of intraventricular hemorrhage

Alberto Feletti1, Luca Basaldella2, Alessandro Fiorindi3

  • 1Department of Neurosciences, Biomedicine and Movement Sciences, Institute of Neurosurgery, University of Verona, AOUI Verona, Polo Chirurgico "P. Confortini", P.le Stefani 1, 37126, Verona, Italy. alberto.feletti@univr.it.

Acta Neurochirurgica
|July 24, 2020
PubMed

Insights

Flexible neuroendoscopy effectively removes intraventricular blood, reducing intracranial pressure and complications. This minimally invasive approach improves outcomes for patients with intraventricular hemorrhage.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Procedures
  • Neurocritical Care

Background:

  • Intraventricular hemorrhage (IVH) is a significant negative prognostic factor in neurological conditions.
  • Prompt and aggressive management is crucial to mitigate intracranial hypertension associated with IVH.

Purpose of the Study:

  • To evaluate the efficacy of flexible neuroendoscopic aspiration for managing intraventricular hemorrhage.
  • To assess the potential of this technique in restoring cerebrospinal fluid (CSF) pathways and reducing complications.

Main Methods:

  • Utilized a flexible neuroendoscope for navigation within the ventricular system.
  • Performed aspiration of blood clots from all four ventricles.
  • Assessed the restoration of CSF flow from the lateral ventricles to the foramen of Magendie.

Main Results:

  • Complete restoration of CSF pathways was achieved.
  • The technique demonstrated the ability to navigate and aspirate blood clots effectively.

Conclusions:

  • Flexible neuroendoscopic aspiration of IVH offers immediate reduction of intracranial hypertension.
  • This method can decrease external ventricular drain (EVD) obstruction and replacement rates.
  • Neuroendoscopic aspiration may reduce infection rates and shunt dependency in patients with IVH.
Abstract

Keywords:
AneurysmBrain ventriclesEVDEndoscopyFlexibleHemorrhageIVH

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