Endoscopic evacuation of intracerebral haemorrhage
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A new combination of technologies has been used for the evacuation of intracerebral haemorrhages: The aim is 1. minimal trauma to cerebral tissue in the surgical approach, 2. atraumatic rather than complete removal of blood clots, 3. better prevention of rebleeding.
Via a 1 cm burrhole, a 6 mm Ø endoscope is introduced and connected to a video display. Using a suction-irrigation system in the endoscope, fluid turbulence and rhythmic pressure variation in the haematoma cavity at 10–15 mm Hg allow the evacuation of the haematoma under visual control. Bleeding vessels can be coagulated using a 1.5 mm Ø Neodym YAG Laser Microtube.
If a small craniotomy is performed instead of only a burrhole, facilities for intraoperative ultrasonic display of the haematoma provide additional control thereby enhancing precision and protection of cerebral tissue on approaching the haematoma and during its evacuation.
KeywordsIntracerebral haemorrhage endoscopic evacuation Laser ultrasound
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