Hiroaki Neki1,2, Aoto Shibata3, Hiroyuki Komine3, Shinya Kohyama4, Fumitaka Yamane5, Shoichiro Ishihara6, Yuichiro Kikkawa3. 1. Department of Neurosurgery, Saitama Cardiovascular and Respiratory Center, Kumagaya, Saitama, Japan. nekihiro1004@yahoo.co.jp. 2. Department of Endovascular Neurosurgery, International Medical center Saitama Medical University, Hidaka, Saitama, Japan. nekihiro1004@yahoo.co.jp. 3. Department of Neurosurgery, Saitama Cardiovascular and Respiratory Center, Kumagaya, Saitama, Japan. 4. Department of Endovascular Neurosurgery, International Medical center Saitama Medical University, Hidaka, Saitama, Japan. 5. Department of Neurosurgery, Teikyo University School of Medicine, Itabashi, Tokyo, Japan. 6. Department of Neurosurgery, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan.
Abstract
BACKGROUND: Although flexible endoscopy is effective for intraventricular lesions, it is less frequently used for hemorrhagic cases. In some hemorrhagic strokes, blood clots may plunge into the cerebral aqueduct and cause acute obstructive hydrocephalus. A flexible endoscope can aspirate clots and prevent acute hydrocephalus. METHODS: Here, we report four cases of hemorrhage: one of intracerebral hemorrhage and three of subarachnoid hemorrhages. RESULTS: In all cases, acute hydrocephalus was not apparent upon admission. Sudden comatose occurred; computed tomography revealed acute obstructive hydrocephalus with a strangulated clot in the cerebral aqueduct. We performed aspiration of the strangulated clot using a flexible endoscope. Consciousness improved in all cases, and acute hydrocephalus was prevented in all cases. CONCLUSION: The use of simple flexible endoscopic aspiration for clots might be a beneficial and less-invasive procedure for acute obstructive hydrocephalus caused by a small clot with hemorrhagic stroke.
BACKGROUND: Although flexible endoscopy is effective for intraventricular lesions, it is less frequently used for hemorrhagic cases. In some hemorrhagic strokes, blood clots may plunge into the cerebral aqueduct and cause acute obstructive hydrocephalus. A flexible endoscope can aspirate clots and prevent acute hydrocephalus. METHODS: Here, we report four cases of hemorrhage: one of intracerebral hemorrhage and three of subarachnoid hemorrhages. RESULTS: In all cases, acute hydrocephalus was not apparent upon admission. Sudden comatose occurred; computed tomography revealed acute obstructive hydrocephalus with a strangulated clot in the cerebral aqueduct. We performed aspiration of the strangulated clot using a flexible endoscope. Consciousness improved in all cases, and acute hydrocephalus was prevented in all cases. CONCLUSION: The use of simple flexible endoscopic aspiration for clots might be a beneficial and less-invasive procedure for acute obstructive hydrocephalus caused by a small clot with hemorrhagic stroke.
Authors: Kun Hou; Xiaobo Zhu; Yang Sun; Xianfeng Gao; Jinchuan Zhao; Yang Zhang; Guichen Li Journal: World Neurosurg Date: 2016-12-31 Impact factor: 2.104