A Case of Combination Treatment of Coil Embolization and Neuroendosopic Intracerebral Hematoma Removal in Ruptured Distal ACA Aneurysm in Hybrid OR

Abstract

  The standard procedure for treating an aneurysmal intracerebral hematoma (ICH) is a concomitant treatment of surgical clipping and ICH evacuation. We report a case of an alternative, minimally invasive strategy using coil embolization for isolating the ruptured aneurysm, followed by neuroendoscopic hematoma evacuation in a hybrid operating room.

  A 52-year-old female patient presented with sudden headache and was admitted to our hospital. Observation revealed subarachnoid hemorrhage (SAH) with intracerebral hematoma in the right frontal lobe caused by a ruptured aneurysm in the left distal anterior cerebral artery. We performed coil embolization of the ruptured aneurysm followed by hematoma evacuation using neuroendoscopy concomitantly in our hybrid operating room. This technique was successful, and the patient recovered and was discharged on day 34 with modified Rankin Scale score of 1.

  Coil embolization followed by neuroendoscopic hematoma evacuation provides an alternative, less invasive treatment strategy in cases of ruptured aneurysms presenting with intraparenchymal hematoma.