Abstract
OBJECTIVE : To evaluate the efficacy of the endoscopic hematoma aspiration treatment method, we compared the outcome at three postoperative months of our patients with those reported in 1989 for conventional aspiration and craniotomy. METHODS : In this study, we surgically treated 92 patients admitted to our hospital and affiliated hospitals with putaminal hemorrhage using a rigid neuroendoscope. RESULTS : The average hematoma aspiration rate was 85% (range, 55-100%), and was 82% even in the acute phase. The results of a cooperative study in Japan in 1989 were compared with those for 62 of our patients who participated in a follow-up survey of Activites of Daily Living three months postoperatively. For NG IVa patients, prognosis following endoscopic surgery was significantly better than that after conventional stereotactic aspiration, and for NG II and III patients, it was significantly better than hematoma removal by craniotomy. CONCLUSION : Endoscopic surgery for intracerebral hemorrhages enables the surgeon to observe the hematoma clearly on the monitor, and also to manage cases of intraoperative bleeding by promoting hemostasis. In addition, it is applicable to the surgical treatment of large hematomas in the acute phase, because it can be used conveniently and quickly. This endoscopic method combines the beneficial features of safety and reliability of craniotomy with those of minimal invasiveness and convenience of conventional stereotactic aspiration to treat intracerebral hemorrhage effectively.
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