Does acute endoscopic evacuation improve the outcome of patients with spontaneous intracerebral hemorrhage?

A new endoscopic technique is presented, which allows burr hole evacuation of intracerebral hematomas under video control. Clot removal is achieved using a suction-irrigation system built in the 6-mm-diameter endoscope; in addition, an ultrasonic morcellement device has been developed for transendoscopic application. Small bleeding vessels in the hematoma cavity can be coagulated using a 1.5 mm Neodym YAG Laser microprobe introduced through the endoscope under visual control. A randomized prospective study has been started to raise again the question of indications for the surgical treatment of intracerebral hemorrhages, comparing medical treatment with the new surgical technique.