First Experience of Endoscopic Hematoma Evacuation in the Treatment of Intracerebral Hematoma with Cone-beam Computed Tomography

Abstract

Background and Purpose: A safe surgery for treating intracerebral hemorrhage (ICH) that reduces the risk of perioperative complications is warranted. Although endoscopic hematoma evacuation is an established treatment for ICH, the surgical indication regarding its application remains controversial. Recently, the use of cone-beam computed tomography (CBCT) with endoscopic hematoma evacuation has been reported, especially for evaluating residual hematomas. This report describes our experience of performing endoscopic hematoma evacuation with CBCT to treat ICH.

Methods: CBCT was used immediately before and during the surgery. We found a residual hematoma and closed the wound. If hematoma remained, we continued the procedure. After the surgery, the CBCT and regular CT images were compared.

Results: Seven patients underwent endoscopic hematoma evacuation with CBCT in the operating room over the past 2 years. In one of those 7 cases, a hematoma was evacuated before closing the wound and no residual hematomas were identified in the postoperative CT for any of the cases.

Conclusion: CBCT is an effective treatment for endoscopic hematoma evacuation, which does not leave any residual hematomas. Endoscopic hematoma evacuation with CBCT was found to be a safe procedure in our study.