Open AccessENDOSCOPIC INTRAVENTRICULAR HEMORRHAGE REMOVAL: CLINICAL OBSERVATION AND TECHNICAL FEATURES
Author(s) -
И. М. Годков,
V. G. Dashyan
Publication year - 2019
Publication title -
nejrohirurgiâ
Language(s) - English
Resource type - Journals
eISSN - 2587-7569
pISSN - 1683-3295
DOI - 10.17650/1683-3295-2019-21-2-45-52
Subject(s) - medicine , hydrocephalus , third ventricle , glasgow coma scale , decompensation , intraventricular hemorrhage , endoscopic third ventriculostomy , surgery , lateral ventricles , ventricle , anesthesia , cerebral ventricle , shunt (medical) , coma (optics) , cardiology , pregnancy , physics , pathology , biology , optics , genetics , gestational age
The study objective is to describe a successful endoscopic therapy for a patient with hypertensive ventricular hemorrhage complicated by occlusive third ventricular hydrocephalus. Materials and methods. A 71-year-old patient with hypertensive hemorrhage into the III and IV ventricles, complicated by non-communicating hydrocephalus, was brought to hospital on the 1 st day of the disease onset. Non-communicating hydrocephalus was accompanied by clinical signs of decompensation, depressed level of consciousness up to moderate coma (Glasgow Coma Scale score of 7). Specialists performed emergency endoscopic aspiration of blood clots from the III and IV ventricles and third ventriculostomy. Results. Endoscopically it was possible to remove the clots from the third ventricle and through the cerebral aqueduct from the fourth ventricle. Resuscitation and intensive care measures resulted in a favorable outcome: the patient was released with a moderate neurological deficit – left oculomotor nerve dysfunction. After 4 months, the patient required a ventriculoperitoneal shunt due to disresponsive form of hydrocephalus. Conclusion. Endoscopic aspiration allows removing hematomas from the third and fourth ventricles via the lateral ventricle effectively and safely.