DRAINING PARENCHYMATOUS HEMATOMAS USING A RIGID ENDOSCOPE

( through a 1.5 mm craniectomy )

RAMIREZ-CEBALLOS, JOSE ANTONIO*

MARQUEZ-CASTILLO ROSA MAGDALENA**

 Centro Neurologico de Investigacion Diagnostico y tratamiento,

OAXACA DE JUAREZ OAXACA  MEXICO

Objective:                                 

drain parenchymatous hematomas caused by hypertension,  through a  1.5 mm craniectomy,using a 2.7 mm rigid endoscope

 Material  :

Patients that checked in the hospital from  September 2005  to May 2007. These patients wereincluded with a diagnosis of  parenchymatous hematomas caused by hypertension with a volume over 30cc,  and with progressive neurological  deterioration and  a lower grade  on the Glasgow scale  or more than  two points in less than 24 hours. And  a topographic movement in the middleline  higher than .5 cm

Method:

For this procedure a small   craniectomy was performed, of 1.5cm  so it would allow   a small  cylindrical separator and a rigid  endoscopeof  2.7 mm. This would also allowsus to employ other instruments commonly used.

   Results:

     27 surgeries  were performed in 27 patients to  drain parenchymatous hematomas,  through  endoscopy , performing a  1.5 mm craniotomy that will allow  the drainwithout any further  complications,and  a quick recovery for thepatient  with an  average  post operatory  bleeding  of  150 ml  and no trans-operatory or post operatory  complications

  Conclusions:

 We consider the drain of parenchymatous hematomas  byendoscopy  a very trust worthyalternative. It  reduces thesurgical time and also the bleeding , and the patients’ recovery is very fast.Using a cylindrical separator  permits us a better visualization   of the hematomas and less damage on braintissue.