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Updated: Oct 7, 2025
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Chronic encapsulated intracerebral hematomas: a systematic review
Gianluca Scalia1, Giuseppe Emmanuele Umana2, Antonio Crea2,3
1Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy.
Insights
This review highlights chronic encapsulated intracerebral hematoma (CEICH), a rare brain lesion. Surgery, particularly craniotomy, is recommended for CEICH management, though endoscopic approaches warrant further study.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Chronic encapsulated intracerebral hematoma (CEICH) presents as a rare, slow-growing lesion causing mass effect.
- This study systematically reviews the diagnosis and management of CEICH.
Approach:
- A systematic literature review was conducted using PubMed and Scopus databases.
- Included 40 papers detailing 58 CEICH patient cases, excluding intraventricular or conservatively treated cases.
Key Points:
- Common symptoms include increased intracranial pressure (48.2%), seizures (29.3%), and motor deficits (24.1%).
- Atypical localization (77.6%) and arteriovenous malformation as a frequent cause were noted.
- Craniotomy (53.4%) was the predominant surgical approach.
Conclusions:
- Surgery is advised for CEICH, with craniotomy being the most common method.
- Further research into endoscopic approaches for CEICH is recommended for potential favorable outcomes.
Background:
Chronic encapsulated intracerebral hematoma (CEICH) is a rare type of intracerebral hematoma (ICH) with peculiar radiological features and presenting as subtle slow-growing lesion exerting mass effect. We performed a systematic review of the literature focused on diagnosis and management of patients affected by CEICH.
Material And Methods:
A literature search according to the PRISMA statement was conducted using PubMed and Scopus databases and pertinent Mesh terms. All papers that reported intraventricular CEICH, or CEICH cases treated conservatively or by CT-guided needle aspiration were not included in this study. A total of 40 papers were included in this review, with 58 patients (38 males and 20 females) and a mean age of 41.44 ± 20.05 years (range 1-80).
Results:
Neurological symptoms of onset include those related to an increase in intracranial pressure (ICP) in 28/58 cases (48.2%), seizures in 17/58 cases (29.3%), motor deficits in 14/58 cases (24.1%). The most frequent localization is atypical in 45/58 cases (77.6%). Surgical approach is not specified in 21/58 cases (36.2%), craniotomy was performed in 31/58 cases (53.4%), craniectomy in 5/58 cases (8.6%) and only in one case (1.7%) an endoscopic approach was performed. CEICH are usually located in an atypical site.
Conclusions:
There is not an association with anticoagulants and antiplatelets intake. Arteriovenous malformation is the most frequent cause. Surgery is suggested, and craniotomy is the most used approach even if further investigation should be directed to analyze the efficacy of endoscopic approach of these lesions, which may show favorable outcome.
