A new expandable cannula system for endoscopic evacuation of intraparenchymal hemorrhages

The authors describe a newly developed expandable cannula to enable a more efficient use of an endoscope in removing intraparenchymal spontaneous hypertensive intracerebral hematomas. The cannula is introduced like a conventional brain cannula, using neuronavigation techniques to reach the targeted hematoma accurately, and, once deployed, conventional microsurgical techniques are used under direct endoscopic visualization. This method was used in 6 patients, and, based on the results of intraoperative intracranial pressure monitoring and postoperative CT scanning, the authors were able to achieve good hematoma removal. They found that by using the expandable cannula, efficient endoscopic surgery in the brain parenchyma was possible.

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A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas

Journal of Neurosurgery ◽

10.3171/jns.2000.92.6.1053 ◽

2000 ◽

Vol 92 (6) ◽

pp. 1053-1055 ◽

Cited By ~ 80

Author(s):

Tetsuhiro Nishihara ◽

Akira Teraoka ◽

Akio Morita ◽

Keisuke Ueki ◽

Keisuke Takai ◽

...

Keyword(s):

Endoscopic Surgery ◽

Brain Parenchyma ◽

Bleeding Point ◽

Content Type ◽

Minimal Invasiveness ◽

Surgical Evacuation ◽

Endoscopic Evacuation ◽

Surgical Field ◽

The Brain ◽

Fine Print

✓ The authors advocate the use of a transparent sheath for guiding an endoscope, a simple and unique tool for endoscopic surgery, and describe preliminary results of its application in the evacuation of hypertensive intracerebral hematomas. This sheath is a 10-cm-long tube made of clear acrylic plastic, which greatly improves visualization of the surgical field through a 2.7-mm nonangled endoscope inserted within. Between April 1997 and December 1998, the authors performed endoscopic evacuation of intracerebral hematomas by using this sheath inserted into the patients' heads through a burr hole. In nine consecutive cases in which the hematoma was larger than 40 ml in volume, nearly complete evacuation (86–100%) of the lesion was achieved without complication. Excellent visualization of the border between the brain parenchyma and the hematoma facilitated accurate intraoperative orientation, and also allowed easy identification of the bleeding point. Thus, this combination of sheath and endoscope achieves both minimal invasiveness and the maximum extent of hematoma removal with secure hemostasis. This tool will reduce the inherent disadvantage of endoscopic procedures and may expand their application in other areas of neurosurgical management.

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Tension pneumocephalus as a complication of intracranial pressure monitoring: A case report

Indian Journal of Neurotrauma ◽

10.1016/s0973-0508(07)80025-6 ◽

2007 ◽

Vol 04 (02) ◽

pp. 115-118 ◽

Cited By ~ 5

Author(s):

Aleksander M Vitali ◽

Andries A le Roux

Keyword(s):

Intracranial Pressure ◽

Head Injuries ◽

Intracranial Pressure Monitoring ◽

Unusual Complication ◽

Pressure Monitoring ◽

Pressure Monitor ◽

Tension Pneumocephalus ◽

Blunt Head Trauma ◽

The Brain ◽

Tomography Scan

AbstractIntracranial pressure monitoring has become routine in the management of severe head injuries. We describe an unusual complication secondary to intracranial pressure monitoring with subdural cup catheter. A 35 year-old man was admitted to the Neurosurgery Department following blunt head trauma. He underwent insertion of subdural cup catheter for monitoring of intracranial pressure. A progress computed tomography scan of the brain revealed tension pneumocephalus. As far as the authors are aware, this is the first reported case of tension pneumocephalus resulting from insertion of a subdural intracranial pressure monitor.

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