Hybrid Operating Room for Combined Neuro-Endovascular and Endoscopic Treatment of Ruptured Cerebral Aneurysms with Intra-ventricular Hemorrhage

World Neurosurgery
Ryosuke MoriYuichi Murayama

Abstract

Intra-ventricular hemorrhages (IVHs) due to ruptured cerebral aneurysms often have poor outcomes. Treatment challenges include co-morbidities, increased intra-cranial pressure (ICP) due to IVH, and the risk of re-bleeding. Two cases of severe IVH accompanied by acute hydrocephalus due to ruptured aneurysm were treated with coil embolization followed by endoscopic hematoma evacuation as a single treatment session in a hybrid operating room (Hybrid OR) equipped with a multi-purpose angio biplanesystem. The first case was an 84-year-old female with a ruptured basilar top aneurysm, who presented with Hunt and Hess (H&H) Grade 5 subarachnoid hemorrhage (SAH) with packed IVH. The second case was a 43-year-old male with a ruptured anterior communicating artery aneurysm who presented with H&H Grade 5 SAH with packed IVH. In both cases, endovascular coil embolization was performed first to prevent intra-operative bleeding. The coiled aneurysms suddenly appeared on the screen of the endoscope during the hematoma removal which could have led to massive re-bleeding if not treated previously. Neither patient needed a re-insertion of the ventricular drainage or developed chronic hydrocephalus during the hospitalization. The Hybrid OR enabled...Continue Reading

References

Sep 11, 2002·Journal of the Neurological Sciences·J Ricardo Carhuapoma
Sep 8, 2005·Southern Medical Journal·K N FountasJ S Robinson
Jun 17, 2006·Journal of Neurosurgery·Yuichi MurayamaToshiaki Abe
Jul 13, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·P LongattiA Martinuzzi
Nov 24, 2006·Stroke; a Journal of Cerebral Circulation·Catharine A HellingmanGabriël J E Rinkel
Dec 9, 2008·Minimally Invasive Neurosurgery : MIN·H HamadaS Endo
Jun 5, 2012·Journal of Neurointerventional Surgery·Yuichi MurayamaToshiaki Abe
Jul 9, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mitsutoshi IwaasaTooru Inoue

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Citations

Aug 5, 2017·Chinese Medical Journal·Li-Gang ChenUNKNOWN Keyhole Microneurosurgery Consensus Group of Chinese Neurosurgical Society
Dec 7, 2018·Neurology India·Shailendra RatreYad Ram Yadav
Jun 3, 2021·International Journal of Molecular Sciences·Lu-Ting Kuo, Abel Po-Hao Huang

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