Retrospective analysis of effects and complications in cases treated with endoscopic evacuation of intracerebral hemorrhage

We described our experience of 22 cases treated with endoscopic evacuation of intracerebral hematoma, including 16 putaminal, 3 thalamic, and 1 cerebellar hemorrhages. All endoscopic procedures were performed under local anesthesia. A rigid-rod endoscope and a suction device attached was introduced through a transparent sheath into the hematoma cavity. Putaminal hemorrhage was sufficiently evacuated (56-100%), but thalamic hemorrhage was insufficiently removed (less than 40%). In 3 cases, postoperative CT demonstrated enlargement of the hematoma after the endoscopic procedure. In one case, postoperative rebleeding was recognized on a postoperative follow-up CT scan. In 2 cases, uncontrollable arterial bleeding occurred during the endoscopic procedure, followed by craniotomy and removal of the hematoma under a microscope. Endoscopic hematoma evacuation should be an efficient procedure for intracerebral hemorrhage after a secure method of hemostasis during the endoscopic evacuation process has been developed.