Background: Intracranial aneurysms are common vascular malformation occurring in 1-2% of the population and accounting for 80-85% of nontraumatic subarachnoid hemorrhages. About 10% of the ruptured aneurysm causing subarachnoid hemorrhage (SHA) develop intraventricular hemorrhage (IVH). In this scenario, the external ventricular drain (EVD) is a usual treatment for IVH. To reduce the time for the clot absorption, the neuroendoscopy with clot removal and ventricular irrigation is a feasible option, although not routinely used.
Case Description: This 2D video shows a case of a 60-year-old female, with sudden headache associated with nausea and vomit. The brain angiotomography revealed aneurysm in the communicating segment of the left internal carotid artery, with 10.5 mm of diameter; also showed intraparenchymal, subarachnoid, and IVH, with a Fisher Modified Grade of 4 and a prompt aneurysm clipping and EVD were performed. Two days after the first surgical procedure, a neuroendoscopy was performed to remove the ventricular clots and improve the patient outcomes.
Conclusion: In the presented case, at the 6 postoperative month, the patient was Grade 1 in the Rankin Modified Scale and without hydrocephalus. This procedure can be used routinely as an additional tool to microsurgical clipping to improve patients outcome.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710481 | PMC |
| http://dx.doi.org/10.25259/SNI_680_2020 | DOI Listing |
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