Endoscopic evacuation of putaminal hemorrhage: how to improve the efficiency of hematoma evacuation

Background: A unique method of evacuation of hypertensive putaminal hemorrhage (HPH) using a stainless steel tube as a corridor under the assistance of a rigid endoscope is described. A simplified method to determine the precise location for burr hole placement is also reported. Methods: From May 2003 to April 2004, 9 patients with HPH underwent endoscopic surgery in our hospital. Two different entry sites (temporal and frontal) were used to approach the hematoma in our series. Results: The hematoma evacuation rate was more than 90% (median 93%) with the frontal approach and 84% with the temporal approach. Conclusions: Using a combination of a stainless steel tube, rigid endoscope, and coagulation suction with a frontal approach can facilitate optimal evacuation of HPH. (c) 2005 Elsevier Inc. All rights reserved.