Biportal endoscopic removal of a primary intraventricular hematoma: Case report

Primary intraventricular hematomas account for approximately 6% of all intr acerebral hematomas. If the clot blocks cerebrospinal fluid (CSF) pathways, surgical intervention, which may be of different types, can be life-saving . In the case reported here, after careful preoperative planning the use of two rigid endoscopes permitted the removal of most of the intraventricular clot and restoration of CSF circulation by creation of a 3(rd) ventriculos tomy within the same procedure and no later treatment was necessary, Repeat ed CT scans proved that only a small portion of the intraventricular clot r emained in the ventricular system, The ventricular size normalised, and the patency of the artificial hole in the floor of the 3(rd) ventricle was dem onstrated both by the rapidly improving clinical picture of the patient and by flow-sensitive MRI studies, For individuals who suffer primary intraven tricular hemorrhage and later develop occlusive hydrocephalus, endoscopic r emoval of the clot and 3(rd) ventriculostomy might offer a more adequate tr eatment option than external ventricular drainage.